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HRCoE sets an ‘audacious goal’ for medical simulation and training

By Tish Williamson | Director, Communications, Health Readiness Center of Excellence | May 29, 2019

JOINT BASE SAN ANTONIO-FORT SAM HOUSTON, Texas —

A new Directorate of Simulation, or DOS, has been established at the Health Readiness Center of Excellence, or HRCoE, at Joint Base San Antonio-Fort Sam Houston.

The directorate is charged with coordinating and incorporating all medical simulation efforts across the full spectrum of medical and military operations. Key stakeholders were brought together May 15-16 for a Strategic Medical Simulation Synchronization Summit to begin developing relationships and unity of effort.

At the summit, Maj. Gen. Patrick D. Sargent, HRCoE commanding general, provided his vision of the future and likened the challenge before them as our “go to the moon” opportunity.

He told the audience that the audacious goal wasn’t ensuring a person made it into space and back alive. The audacious goal was to ensure every Soldier, Sailor, Airmen and Marine makes it into combat and back alive. Simply put, their goal is zero preventable deaths on the battlefield.

Since it was assembled Feb. 12, DOS leadership has worked hard to establish themselves as the central focal point for Army Medical Modeling and Simulation initiatives with the responsibility for the development and execution of medical simulation training and the emerging medical simulated training environment, or STE.

They have already begun to leverage internal stakeholders like Program Executive Officer for Simulation, Training and Instrumentation, or PEO-STRI, STE Cross Functional Team, U.S. Army Futures Command and the Defense Medicine Modeling and Simulation Office, or DMMSO, to help outline medical requirements.

Col. Wes Clarkson, HRCoE’s DOS Director said some early quick wins include working with PEO-STRI to add medical scenarios and vignettes to the Maneuver Center of Excellence’s Soldier, Squad Virtual Trainer and Integrated Visual Augmentation System.

DOS also provided specifications, contents, functions and usages for the Individual First Aid Kit and Combat Lifesaver Bag for modeling use in the Maneuver CoE’s project.

Within just 93 days of formation, having already made those and other significant contributions to the seemingly small world of medical simulations, HRCoE DOS brought together nearly 50 medical, simulation, training, and educations experts during a working session called the Strategic Medical Simulation Synchronization Summit, or SMS3.

There were subject matter experts in attendance from PEO-STRI, DMMSO, Brooke Army Medical Center, U.S. Army Futures Command and many other relevant external and HRCoE internal organizations.

The two-day event, hosted by the HRCoE at Joint Base San Antonio-Fort Sam Houston May 15-16, was the first of many future synchronization events that will grow in both size and scope.

The overall purpose of the event was to ensure representation from as many subject matter experts as possible, orient DOS to the stakeholders’ missions and vice versa, to clearly outline and define the goals set by the command, and to solicit the collaboration and cooperation that is needed to be successful in this arduous endeavor.

“Today, May 16, 2019, is the day the Health Readiness Center of Excellence announces our audacious goal: we are unwilling to postpone our strategic pivot to fundamentally transform and exponentially improve the way we train to save lives on the battlefield through better use of 21st century technology,” Sargent said. “This is our shot at the moon and we want to take all of you with us.” 

On day two of the event, Sargent, who has commanded the HRCoE since June 2018, told the audience that it is not sufficient for doctors to be fully trained because eliminating preventable deaths on the battlefield depends on ensuring the entire medical team, across the continuum of care, is fully trained. He reiterated that proficiency is assured through standard Individual Critical Task Lists, or ICTLs, which lead to a capable team proficient in supported collective tasks.

Sargent, a medical evacuation pilot, described his vision for ICTLs and the ability to effectively evaluate the proficiency of medical soldiers upon arrival to each operational assignment. The concept, similar to an aircrew training program, would evaluate readiness through a series of written, oral and practical evaluations upon arrival to an operational assignment.

“It’s not enough to call Soldiers and providers well trained if we do not ensure they maintain their proficiency when they go to their follow-on assignment or MTF,” he said.

Sargent sees the opportunity to gain true proficiencies in medical competencies through advances in STE, as a vital element in any future operational medicine training program.

Currently, pre-deploying individuals or medical teams are provided optional hands-on Tactical Combat Casualty Care training as a three to five-day immersive refresher before they are considered trained and prepared for the rigor of combat medicine.

These courses, like Tactical Combat Medical Care or the Brigade Combat Team Trauma Training, are classified by graduates as some of the most relevant training they could receive prior to a deployment. Still, he says, Army medicine should go further.

“Can you imagine allowing a new pilot to spend a few days in a helicopter trying to maintain a steady, 10-foot hover and then check them off as fully trained and ready for flight on day five?” Sargent asked. “Let’s stop justifying what we had to do in the past, purely out of necessity, and focus on establishing new standards through innovative methods to accomplish standardized, effective training methods and standards with an operational medicine focus that yields proficiency over familiarization.”

To close out the summit, Jay Harmon, deputy to the commanding general, HRCoE, who has direct oversight over the DOS program, thanked attendees for contributing their time, being transparent and sharing their knowledge and skills with the team.

“The CG laid out his vision to the CoE and his challenge to you today,” Harmon said. “It’s now our job, together, to operationalize that vision.”

Harmon outlined how the next steps after the SMS3 are to formalize the team and add anyone else who should be in the room, establish a timeline and then create a plan of action complete with milestones and priorities. He said the CG believes DOS is starting out behind the power curve and has lost the strategic advantage when it comes to medical simulations.

“As the boss said, we missed the train at the first station, but we are going to catch up and get on the train at the next station,” Harmon said.

The next Health Readiness Center of Excellence Strategic Medical Simulation Synchronization Summit is scheduled for Sept. 25-26 at JBSA-Fort Sam Houston. Contact the Directorate of Simulations at 210-221-0837 for more information.