FALLS CHURCH, Virginia –
The Air Force’s Sustained Medical and Readiness Trained, or SMART, program has become a dynamic training platform. Through tailored training and multidisciplinary opportunities, Air Force medics retain their currency and are ready for the fight.
Through a partnership with the University Medical Center of Southern Nevada, the SMART program provides medics with the necessary hands-on patient experience needed to excel in their medical specialty. While the program is one of the U.S. Air Force School of Aerospace Medicine’s five geographically separated units, it stands out as the only currency training site of its kind, boasting exposure to complex patient cases, and instruction catered to the needs of each medic attending the two-week course.
“We are not a simulation lab-based program. We are purely clinical and medics are going to get hands-on patient care experience they may not always see at their military treatment facility,” said Lt. Col. Matthew Fain, site director for the Air Force’s regional currency site in Las Vegas, Nevada and SMART program critical care instructor. “You are going to be on the floor taking care of patients, you are going to be in the operating room assisting with a surgery, or you might be the surgeon conducting the procedure. The skillsets are based on your medical specialty, whether you are an intensive care unit doctor or a respiratory therapist, we are going to focus on what you need to be successful.”
Because of this flexibility, the SMART program has remained responsive to changing deployed medical requirements.
“Throughout the two weeks, the medics, from physicians to technicians, each share in the education of each other’s specialty,” said Maj. Jennifer Armengual, a registered nurse and SMART program chief of education and training. “We [meet] at the end of the day to share experiences at all levels of care.”
As Fain explains, this multidisciplinary approach enables medics to translate skills from everyday clinical environments to deployed locations.
“I have received critical care air transport team training where you can’t be successful if you just stick to your medical role,” Fain said. “In those environments, we are working in such small teams that our roles overlap, and we need to know how to do that well. We try to bring that mindset into the SMART program training.
“For example, we had a physician assistant attend the program who worked close to the front lines and he wanted to know how to dress and care for wounds. We connected him with a burn team where he worked with nurses and physicians to become more comfortable taking care of extensive wounds.”
The SMART program also complements the deployed-focused Center for the Sustainment of Trauma and Readiness Skills training platform by building clinical skills and providing exposure to complex patient cases and high patient volumes.
“The SMART program is like learning to walk before you run,” said Fain. “If you are not used to taking care of patients on a ventilator or you’re not used to seeing those big orthopedic surgery cases, then we can bring you up to speed for those skills. This then prepares you for the specialized training at C-STARS that trains you to do your job in more challenging environments.”
The SMART program is run through USAFSAM, which is part of the Air Force Research Laboratory’s 711th Human Performance Wing. Each year, the SMART program trains more than 200 medics and relies on a cadre of 13 Air Force medics who are full-time at UMC.
“Because the cadre embeds here, we have built trust and familiarity with our civilian counterparts,” Armengual said. “As a result, the medics who go through the program get more opportunities to work with different types of providers and get more hands-on experience. We also have opportunities to learn from each other. For example, we have a bedside discussion with all of the Air Force nurses about ventilator management and many times civilian ICU nurses have benefited from these discussions as well. These opportunities benefit us all and enrich our practice.”
There are plans to expand the program in the future with more opportunities to build skills to respond to trauma cases in the field, as well as grow the specialty base of the instructors.
“The SMART program’s goal is to reinforce the necessary skills we need to be a ready medical force,” Fain said. “We plan to continue growing the specialty training we can offer, including increasing exposure to pre-hospital care such as [emergency air transport]. Having access to this training ensures our medics stay ready to deploy these critical skills at any moment.”