DTIC ADA327674: Analysis of Distance Learning and Combat Medic Training.

Survival, Water, Medical Field Manuals

Military Manuals

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The  views  expressed  in  this  paper  are  those  of  the 
author  and  do  not  necessarily  reflect  the  views  of  the 
Department  of  Defense  or  any  of  its  agencies.  This 
document  may  not  be  released  for  open  publication  until 
it  has  been  cleared  by  the  appropriate  military  service 
government  agency. 


STRATEGY 


ANALYSIS  OF  DISTANCE  LEARNING  AND 
COMBAT  MEDIC  TRAINING 


LIEUTENANT  COLONEL  JOHN  H.  BROWN,  JR. 

United  States  Army 


DISTRIBUTION  STATEMENT  A: 
Approved  for  public  release. 
Distribution  is  unlimited. 


USAWC  CLASS  OF  1997 


U.S.  ARMY  WAR  COLLEGE,  CARLISLE  BARRACKS,  PA  17013-5050 


1 9970623  222 


USAWC  STRATEGY  RESEARCH  PROJECT 


ANALYSIS  OF  DISTANCE  LEARNING  AND  COMBAT  MEDIC  TRAINING 


by 

LTC  John  H.  Brown,  Jr. 


Colonel  (Ret)  Arthur  F.Lykke,  Jr. 
Project  Advisor 

DISTRIBUTION  STATEMENT  A: 
Approved  for  public 
release.  Distribution  is 
unlimited. 


The  view  as  expressed  in  this  paper  are  those  of 
the  author  and  do  not  necessarily  reflect  the 
views  of  the  Department  of  Defense  or  any  of 
its  agencies.  This  document  may  not  be 
released  for  open  publication  until  it  has 
been  cleared  by  the  appropriate  military 
service  or  government  agency. 


U.S.  Army  War  College 
Carlisle  Barracks,  Pennsylvania  17013 


ABSTRACT 


AUTHOR:  LTC  John  H.  Brown,  Jr.,  USA 

TITLE:  Analysis  of  Distance  Learning  and  Combat  Medic  Training 
FORMAT:  Strategic  Research  Project 

DATE:  4  January  1996  PAGES:  26  CLASSIFICATION:  Unclassified 

The  United  States  government  is  in  the  midst  of  pursuing  avenues 
to  reduce  the  budget  deficit  and  balance  the  budget.  In  efforts  to 
support  government  strategies,  the  military  as  a  whole  must  determine 
cost-savings  alternative  means  to  train  its  personnel  while  still 
training  to  standard  and  meeting  the  expectations  of  the  field  and  the 
service  members  it  trains.  Distance  learning  strategies  that  will 
play  a  big  part  in  the  training  of  Army  personnel  are  well-suited  to 
the  training  of  combat  medics.  In  turn,  the  needs  of  the  combat  medic 
and  the  Army  leadership  will  be  fulfilled  and  contribute  to  Army 
readiness  and  the  national  military  strategy. 


iii 


IV 


TABLE  OF  CONTENTS 


Introduction . 1 

Assumptions . 2 

Training  Strategy  Identification  and  Analysis;  Objectives . 2 

Concepts:  Mission/Needs/ Job  Analysis . 5 

Individual  Task  Identification . 8 

Media  Selection . 12 

Training  Development . 13 

Combat  Medic  Student  Evaluation . 14 

Combat  Medic  Program  Assessment . 15 

Resources:  Manpower . 16 

Funding . 17 

Risk  Assessment . 18 

Conclusion . 19 

Endnotes . 21 

Bibliography . 24 


V 


INTRODUCTION 


It  is  no  secret  that  over  the  past  few  years,  hundreds  of 
legislative  and  voluntary  avenues  have  been  explored  to  reduce  the 
budget  deficit  and  eventually  balance  the  budget.^  In  support  of 
this  national  strategy  has  come  the  U.S.  National  Military  Strategy 
(USNMS)  which  mandates  restructure  of  the  military  services  to  best 
utilize  resources.  The  Army  Modernization  Plan  (AMP)  supports  the 
USNMS  through  strategies  that  will  maintain  a  CONUS-based  Army 
force,  rather  than  a  forward  deployed  force.  As  part  of  the  AMP 
Force  XXI  strategy,  commanders  and  their  soldiers  must  be  able  to 
rapidly  access  information  technology  to  maintain  battlefield 
operations  at  all  levels.^  Army  Training  XXI  is  the  Army's  strategy 
for  training  the  force  with  technologies  that  will  provide  the 
capability  to  train  soldiers,  leaders  and  units  when  and  where  they 
need  it.  In  turn,  the  Army  Distance  Learning  Plan  addresses 
distance  learning  (DL)  applications  and  directs  Major  Commands  to 
develop  DL  plans  to  meet  their  training  requirements.^  The  Medical 
Command's  U.S.  Army  Medical  Department  (AMEDD)  DL  Plan,  developed  by 
the  AMEDD  Center  and  School,  addresses  the  overall  requirements  of 
DL  application  for  medical  training,'*  As  a  result  of  this 
progression,  conversion  of  combat  medic  training  into  DL  format  has 
become  a  priority  for  continued  readiness  in  the  AMEDD.  Thus,  the 
thesis  of  this  analysis  is  logically  meant  to  support  established 
strategies:  DL  will  be  conducted  and  learning  will  be  sustained  so 
that  combat  medics  are  deployable  anytime,  anywhere. 


ASSUMPTIONS 


Certain  assumptions  must  be  in  place  prior  to  implementing  DL 
strategies  in  combat  medic  training: 

(1)  Infrastructure  is  in  place  to  support  DL  initiatives. 

(2)  Training  developers  and  trainers  will  be  prepared  to 
develop  and  conduct  DL  training  format. 

(3)  DL  training  methodology  has  been  trained  and  affirmed  in 
medical  training. 

TRAINING  STRATEGY  IDENTIFICATION  AND  ANALYSIS 
OBJECTIVES 

The  first  and  foremost  objective  in  converting  combat  medic 
training  into  DL  format  is  to  improve  the  combat  medic's  level  of 
readiness  which  in  turn  will  contribute  to  force  readiness.  It  is 
imperative  that  combat  medic  training  be  designed  and  implemented  to 
meet  the  soldier's  training  needs  and  capabilities  as  well  as 
fulfill  the  mission  needs  of  the  soldier's  unit.®  A  tailored  combat 
medic  training  program  will  serve  to  meet  military  occupational 
specialty  qualification  (MOSQ)  requirements,  sustainment  needs,  and 
advanced  combat  medic  leadership  training.  Ability  to  access  on-line 
combat  medic  training  in  garrison,  in  classrooms,  on  training 
ranges,  and  on  the  battlefield  will  afford  individual  soldiers  and 
units  the  opportunity  to  conduct  immediate  just-in-time  training 
without  waiting  for  bureaucratic  approval  processes  and  delivery  of 
training  materials.  The  remote  locations  of  units,  particularly 
reserve  component  units,  as  well  as  frequent  overseas  deployment. 


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severely  hinders  the  conduct  of  needed  training.®  By  meeting  unit 
needs  prior  to  and  even  during  deployment,  DL  can  better  support 
combat  medic  preparation  for  the  mission.  Mission-specific  combat 
medic  training,  such  as,  identification  of  indigenous  diseases  and 
treatment  of  those  diseases  can  be  made  readily  available  in  real 
time  and  in  remote  areas. 

The  combat  medic  DL  training  strategies  will  further  enable  the 
AMEDD  to  meet  the  second  objective  of  providing  standardized 
teaching  methodology  and  content  for  all  combat  medics.  Soldier's 
throughout  the  Army  in  garrison  and  in  remote  parts  of  the  world 
will  receive  the  standardized  training  through  duplicate 
training/learning  events,’  leaving  little  possibility  for  the 
response,  "...but  that's  the  way  they  taught  me  to  do  it  at  Ft. 
Hood."  Standardized  training  can  be  mutually  acquired  across  the 
services.  Tasks  such  as  "administer  an  intramuscular  injection"  can 
be  developed  in  DL  format  and  shared  with  the  other  services  with  no 
concern  for  differences  in  service  orientation  while  eliminating 
duplication  of  effort  and  making  efficient  use  of  resources.® 

The  third  objective  of  combat  medic  DL  establishes  personal 
accountability  for  readiness.  Through  both  local  (unit.  Post 
Education  Centers  and  home)  computers,  for  example,  the  combat  medic 
will  access  world  wide  web  and  bulletin  board  sites  to  obtain  task 
demonstrations,  digitized  lessons,  as  well  as  newsletters.®  In  many 
cases,  the  combat  medic  will  have  on-line  access  to  training  sites 


(AMEDDC&S,  Health  Service  Brigades)  to  obtain  immediate  responses  to 
questions .  The  combat  medic  will  no  longer  have  to  wait  to 
interface  with  an  on-site  trainer,  or  training  classes  given  at 
specified  times,  or  not  at  all.  He  will  log-in  with  a  specific  code 
and  records  of  training  will  be  automatic,  identifying  tasks  trained 
and  the  time  spent  on  each  task,  as  well  as  documenting  evaluation 
of  performance.  Thus,  the  combat  medic  will  receive  immediate 

feedback  to  identify  performance  proficiency  or  deficiency. 
Individual  sustainment  training  and  task  proficiency  will  become  the 
responsibility  of  the  soldier. 

The  reduction  of  time  in  resident  training  will  be  the  greatest 
contributor  to  resource  savings.  Analysis  of  the  existing 
curriculum  by  the  AMEDD  indicates  that  approximately  60%  of  combat 
medic  reserve  component  reclassification  training  and  reserve  and 
active  component  advanced  combat  medic  training  (Basic 
Noncommissioned  Officer  Course  Common  Leader  Training  (CLT) ,  Career 
Management  Field  (CMF) ,  and  91B  Technical  Training;  Advanced 
Noncommissioned  Officer  Course  CLT/CMF  and  91B  Track  Training)  can 
be  eliminated.  Analysis  demonstrates  anticipated  savings  for  per 
diem,  travel,  permanent  change  of  station,  instructor  manpower 
requirements,  and  instructor  certification. Further,  a  reduction 
of  time  in  resident  training  will  generate  more  time  for  the  combat 
medics  to  be  in  their  units  and  to  contribute  to  the  first  objective 
of  increased  readiness. 


CONCEPTS 


MISSION/NEEDS/JOB  ANALYSIS 

To  accomplish  the  above  mentioned  objectives,  the  mission  of 
the  combat  medic  will  be  evaluated.  Is  the  mission  of  the  combat 
medic  the  same  under  the  Force  XXI  plan?  Is  more  expected  of  the 
combat  medic?  Will  the  combat  medic  continue  to  be  a  jack-of-all 
trades .. .medic,  vehicle  mechanic,  helicopter  mechanic?  Will  there 
continue  to  be  a  downward  shift  of  responsibilities?  What  should  be 
the  focus  of  training  for  the  combat  medic?  To  answer  these 
questions,  a  detailed  strategic  plan  will  be  formulated  to  ensure 
that  all  significant  areas  of  concern  and  identified  objectives  are 
thoroughly  evaluated  to  most  effectively  redesign  combat  medic 
training  into  DL  format.  If  resources  are  to  be  used  efficiently, 
if  combat  medic  training  is  standardized,  and  if  combat  medics  are 
to  remain  accountable  for  sustainment  training  and  task  proficiency, 
detailed  analysis  and  planning  are  paramount. 

An  evaluation  of  the  Table  of  Organization  and  Equipment  (TOE) 
and  the  Table  of  Distribution  and  Allowances  (TDA)  will  provide  a 
mission  statement  for  specified  units.  From  these  mission 
statements  comes  a  draft  mission  list.  (This  procedure  will  be 
modified  appropriately  when  a  mission  list  exists  that  requires  only 
review  and  minor  modifications.)  The  draft  mission  list,  with 
concentration  on  the  combat  medic's  mission  within  the  unit,  will  be 


5 


validated  through  one  or  more  forms  of  analysis:  (Information  below 
on  analysis  and  procedures  are  documented  in  TRADOC  Regulation  350- 
70,  Training:  Training  Development  Management,  Processes  and 
Products . ) 

(1)  Content  analysis  is  basically  a  literature  search  of 
doctrinal  manuals,  combat  medic  soldier's  manual,  combat  medic  Army 
Occupational  Surveys,  and  other  documentation. 

(2)  Interview  analysis  consists  of  interviews  with  personnel 
assigned  to  key  combat  medic  positions  including  supervisors  of 
combat  medics.  This  analysis  will  be  conducted  through  both  surveys 
and  face-to-face  interviews.  Though  this  form  of  analysis  can  prove 
costly  in  both  preparation  time  and  survey  admini-stration,  the 
results  are  often  the  most  useful. 

(3)  Observation  Analysis  will  be  performed  through  on-site 
visits  of  organizations /combat  medics  performing  their  mission. 
Collective  training  exercises  are  also  helpful  in  mission  analysis, 
but  are  not  solely  representative  of  combat  missions. 

A  mission  matrices  specific  to  the  combat  medic  will  then  be 
compiled  to  identify  various  missions  of  combat  medics  at  all 
echelons.  This  is  a  top-down  evaluation  of  mission  with  each  level 
building  on  the  previous  higher  level.  As  this  is  accomplished,  the 
developer  will  also  identify  actions  that  are  part  of  collective  and 
individual  tasks.  A  separate  list  will  be  concurrently  compiled  to 
be  used  when  developing  the  collective  and  individual  task 
inventories.  The  final  mission  list  will  then  be  staffed  to  key 


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combat  medic  personnel,  doctrine  writers,  and  combat  developers. 


When  the  mission  list  is  staffed  and  approved,  the  missions 
will  be  analyzed  to  determine  collective  tasks  required  to 
accomplish  the  mission.  Collective  tasks  lists,  both  new  and 
existing,  will  then  be  refined  and  expanded  using  the  same 
analytical  methods  above.  A  task  is  considered  a  collective  task: 

(1)  if  it  requires  group  participation 

(2)  has  specific  start  and  end  points 

(3)  results  in  a  measurable,  observable  product  or 
accomplishment 

(4)  requires  simultaneous  performance  of  task  steps. 

Training  tasks  will  not  be  identified  if  they  are  not  critical 

to  unit  or  combat  medic  performance,  are  not  difficult  to  learn,  are 
performed  by  only  a  small  number  of  combat  medics,  are  rarely 
performed,  or  if  they  will  not  produce  undesirable  effects  if 
performed  incorrectly.  (The  attempt  is  to  delete  tasks  which  would 
waste  resources  and  train  only  significant  tasks.) 

Task  titles  will  then  be  developed  in  a  standard  format.  The 
format  will  resemble  the  same  format  used  to  develop  the  mission 
statement  including  an  action  verb,  an  object,  and  a  qualifier.  At 
this  point,  collective  tasks  will  be  further  developed  by  a 
collective  task  analysis  process.  However,  in  order  to  proceed  with 
the  identification  of  distance  learning  for  the  individual  combat 
medic  this  procedure  will  not  be  pursued  at  this  time. 


7 


Hand-in-hand  with  the  identification  of  collective  tasks  is  the 
performance  of  job  analysis.  Surveys  of  commanders  in  the  field, 
combat  medic  supervisors,  and  combat  medics  themselves  will  be 
developed  to  determine  the  existing,  specific  needs  of  job 
performance  and  leader  expectations  in  both  the  active  and  reserve 
components . Material  and  data  that  guide,  direct,  and  explain  the 
job  activities  of  the  combat  medic  will  allow  for  integration  of 
information  to  determine  job  tasks.  New  equipment  data  should  also 
be  incorporated  in  the  job  analysis. 

INDIVIDUAL  TASK  IDENTIFICATION 

Upon  completion  of  the  combat  medic  job  analysis  and  evaluation 
of  the  results  will  be  compiled  based  on  duty  positions  and  job 
tasks  required  by  the  duty  positions, i.e. ,  individual  tasks.  A  task 
will  be  identified  as  an  individual  task  if  it: 

(1)  Has  identifiable  start  and  stop  points. 

(2)  Has  a  verb  and  an  object  which  are  observable  and 
measurable . 

(3)  Is  a  definite  and  independent  part  of  a  duty  that  is 
performed  for  its  own  sake. 

(4)  Is  a  specific  action  consisting  of  two  or  more  distinct 
steps . 

(5)  Is  performed  in  relatively  short  periods  of  time. 

Task  titles  will  be  developed  using  the  same  procedures  as 
mission  list  development  and  collective  task  title  development. 
Individual  tasks  will  be  compiled  into  a  comprehensive  individual 


8 


task  inventory  (CITI)  which  will  be  subsequently  staffed  with 
appropriate  agencies.  The  CITI  will  be  finalized  based  on  input 
received  during  the  staffing  process. 

Analysis  will  continue  with  the  forming  of  a  Combat  Medic 
Training  Task  Selection  Board  (TTSB) .  The  TTSB  will  be  made  up  of 
seven  to  nine  combat  medics  from  the  grade  of  Sergeant  to  Sergeant 
Major  and  supervisors  of  combat  medics  including  Army  Nurse  Corps 
officers,  Physician  Assistants,  and  Medical  Corps  officers  who  will 
determine  combat  medic  tasks  performance.  Criteria  for  TTSB  voting 
member  selection  will  include  representatives  from  both  reserve  and 
active  component,  TOE/TDA  experience,  critical  care  or  emergency 
trauma  treatment  experience,  a  minimum  of  five  years  of  experience 
as  a  combat  medic  or  supervisor  of  combat  medics.  It  is  preferable 
that  TTSB  members  come  from  areas  outside  of  the  AMEDDC&S  in  order 
to  minimize  prejudices  and  preconceived  notions  about  existing 
combat  medic  training.  The  TTSB  president  is  a  non-voting  member 
and  will  be  an  AMEDD  officer.  Objectives  of  the  TTSB:^^ 

(1)  To  provide  quantitative  expert  board  decisions. 

(2)  To  select  tasks  for  training  based  on  the  systematic  group 
consensus  method. 

(3)  To  produce  a  prioritized  task  list. 

(4)  To  identify  the  appropriate  skill  level  of  task 
performance. 

(5)  To  select  tasks  for  mobilization ‘and  sustainment. 

The  TTSB  will  begin  with  a  series  of  briefings  including:  an 


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unclassified  threat  briefing;  personnel  proponency  issues  and 
changes  in  career  management  field  91;  combat  and  doctrine 
development  issues  and  potential  use  of  selected  tasks  in  training 
development.  Administrative  guidance  on  selection  procedures  and 
training  task  prioritization  will  emphasize  task  modifications  and 
prioritization. 

Each  individual  task  title  on  the  CITI  will  be  reviewed  by  the 
TTSB  members  to  ensure  that  all  titles  accurately  reflect  job 
performance  requirements.  During  this  process,  tasks  will  also  be 
analyzed  in  a  two  stage  process.  First,  the  tasks  will  be  assigned 
a  select/nonselect  score  based  on  whether  TTSB  members  judge  that 
training  is  or  is  not  required.  This  step  can  also  be  performed  by 
the  TTSB  members  prior  to  arriving  for  the  TTSB  with  tasks  titles 
being  modified  when  the  TTSB  convenes.  Tasks  will  be  carefully 
reviewed  to  determine  if  they  are  true  task  statements  and  not 
steps  of  a  task.  All  tasks  receive  a  score  of  "0"  for  nonselect  and 
"1"  for  select.  The  selection  score  will  be  an  average  of  all  TTSB 
members'  decisions. 

Task  priority  ratings  are  determined  during  the  second  stage. 
Tasks  with  100%  agreement  will  not  require  discussion.  Tasks  with 
variances  in  selection  scores  will  be  discussed  and  TTSB  members 
will  be  permitted  to  change  their  selections.  Tasks  will  then  be 
prioritized  using  a  seven-point  rating  scale.  All  resulting  task 
priorities  rated  seven,  six,  or  five  are  critical  tasks;  four, 
three,  or  two  are  mission  essential  tasks;  one  is  other  tasks.  The 


10 


scores  will  then  be  averaged  to  produce  an  average  priority  rating 
(APR).  An  APR  of  4.5  or  greater  is  generally  accepted  as  the 
standard  for  identifying  critical  tasks.  This  rating  is  the 
midpoint  between  critical  and  mission  essential.  Task  category 
identification  is  as  follows: 

(1)  Critical  tasks  are  tasks  determined  to  be  essential  to 
wartime  mission,  duty  accomplishment,  and/or  survivability.  The 
training  base  and/or  unit  will  train  all  critical  individual  tasks. 
Many  critical  tasks  will  be  included  in  the  Soldier's  Manual  and 
other  sustainment  documents.  (An  APR  of  4.5  to  7) 

(2)  Mission-Essential  tasks  are  tasks  necessary  to  support  the 
stated  mission  of  a  combat  medic  in  a  peacetime  environment.  The 
training  base/unit  should  train  all  mission  essential  tasks.  (An  APR 
of  below  4.5  to  2.0) 

(3)  Other  essential  tasks  contribute  to  the  performance  of 
critical  or  mission-essential  tasks,  but  alone  will  not  affect 
mission  attainment  (example:  administrative  tasks) .  (An  APR  of  1.0 
to  2.0) 

The  relative  order  of  tasks  on  the  final  list  represents  a 
training  policy.  A  recommended  training  strategy  is  to  choose  tasks 
from  the  critical  category.  Once  tasks  have  been  identified  by 
criticality,  each  task  will  be  identified  in  the  following 
categories : 

(1)  Skill  level  will  identify  the  skill  level  where  tasks  will 
be  trained. 


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(2)  Mobilization  tasks  are  necessary  to  perform  a  recognized 
combat  or  wartime  job  function;  relates  to  Army  Training  Exercise 
Plan  (ARTEP) ,  threat,  doctrine,  or  combat  function. 

(3)  Sustainment  training  tasks  are  those  tasks  which  require 
performance  maintenance  in  order  to  sustain  skill  performance. 

The  voting  results  will  be  finalized  and  approved  by  the 
Commander,  AMEDDC&S. 

MEDIA  SELECTION 

Following  approval,  each  task  will  then  be  analyzed  by  training 
developers  and  subject-matter  experts  to  determine  if  the  task  can 
be  trained  in  DL  format  and  the  appropriate  DL  media  in  which  to 
train  the  task.  Training  developers  will  then  develop  tasks  using 
a  systematic  approach. In  order  to  select  a  delivery  system  for 
specific  curriculum.  Hardy,  et.al.  recommend  that  the  program  level 
and  distance  learning  infrastructure  must  first  be  considered, 
followed  by  a  formulation  of  instructional  design  and  selection  of 
appropriate  technology  based  on  instructional  content  and  design. 
Goals  and  objectives  will  be  clearly  defined.^®  Hardy,  et.  al. 
suggest  that  technology  selection  can  be  determined  by  placing 
curriculum  in  two  categories:  motion  and-  non-motion.  Motion 
indicates  that  motion  is  a  mandatory  part  of  the  instruction 
delivery  necessary  for  the  student  to  grasp  concepts.^''  Practical 
exercises  in  combat  medic  training  such  as,  initiating  an 
intravenous  infusion,  require  motion;  in  this  case,  hands-on 
performance  of  a  specified  task.  Non-motion  curricula  are  those 


12 


that  do  not  require  motion.  Didactic  and  lecture  modes  of 
instruction  fit  into  this  category.  Selection  for  distance  learning 
strategies  can  be  made  from,  but  are  not  limited  to,  the  following: 
paper-based  instruction  in  the  form  of  correspondence  courses, 
training  manuals,  etc.;  task-based  videos;  video  teletraining; 
computer-based  instruction;  interactive  video;  on-line  instruction 
(bulletin  board,  world-wide  web) 

TRAINING  DEVELOPMENT 

Combat  medic  distance  education  training  development  will  be 
preceded  by  a  detailed  learner  profile  of  a  large  sample 
population.^®  When  analyzed,  the  profile  information  will  assist 
training  developers  and  instructors  in  the  training  development  and 
instruction  processes .  Information  obtained  will  enable  the 
training  developers  to  circumvent  areas  that  may  prove  detrimental 
to  the  overall  student  population  as  well  as  enhance  those  areas 
that  will  produce  successful  learning. 

Distance  education  students  often  experience  little  involvement 
with  limited  opportunities  to  ask  questions  or  share  ideas.  When 
possible,  interaction  will  be  considered  a  key  element  in 
instructional  development.^®  As  much  as  possible,  instruction  will 
include  meaningful  interactions  between  and  among  the  students, 
between  instructors  and  student  personnel,  and  with  instructional 
materials .  Two-way  communications  also  motivate  students  and  often 
results  in  student  enjoyment.  Appropriate  practice  and  interaction 
are  also  critical  to  support  and  enforce  learning  outcomes. 


13 


Technologies  are  available  that  facilitate  learning  both  in  an 
individual  setting  and  in  a  group  or  classroom  setting.  All 
available  technologies  must  be  investigated  to  determine  the  most 
appropriate  use  in  all  combat  medic  training  environments. 
Technology  selection  must  take  into  consideration  characteristics  of 
the  target  audience  and  the  desired  results  of  training. 

Motivation  is  also  a  key  factor  and  is  enhanced  by  immediate 
feedback. Automation  technologies  that  use  branching  techniques, 
for  example,  provide  immediate  feedback  and  enforce  the  student's 
selection  of  proper  performance.  This  method  provides  a  high  level 
of  motivation  that  traditional  non-interactive  computer-based  can 
not  provide.  (Branching  techniques  allow  the  student  to  proceed 
until  an  error  is  made,  at  which  point  the  student  must  return  to 
the  spot  where  he  last  performed  a  step  of  the  task  correctly.) 

COMBAT  MEDIC  STUDENT  EVALUATION 

Combat  medic  student  success  will  be  evaluated  through  tests 
derived  from  a  centralized  test  data  bank.  Each  test  generated  for 
a  specific  area  of  concentration  will  be  different  from  previous  or 
successive  tests.  All  students  will  take  a  criterion-based  pretest 
and  posttest  and  will  be  required  to  pass  one  of  the  two.  If  the 
pretest  is  successfully  passed  the  student  will  be  able  to  proceed 
to  the  next  lesson.  The  student  will  also  be  required  to  pass 
hands-on  proficiency  tests  where  appropriate  in  order  to  ensure 
mastery  of  patient  treatment  tasks.  If  the  student  is  unable  to 
pass  either  the  pretest  or  posttest,  he/she  will  be  given  remedial 


14 


training  and  retested.  As  distance  learning  training  is  conducted, 
methodology  will  be  adjusted  as  appropriate  to  best  evaluate  student 
learning. 

COMBAT  MEDIC  PROGRAM  ASSESSMENT 

The  success  of  the  combat  medic  program  will  be  determined  by 
examining  the  effectiveness  and  worth  of  instruction  which  is  based 
on  the  learners '  needs .  A  pilot  course  validation  will  be  conducted 
using  a  control  group.  Results  of  the  training  will  be  reviewed  and 
evaluated  by  combat  medic  subject-matter  experts  and  training 
developers  to  determine  if  there  is  need  for  revision  including 
changes,  additions,  or  different  learning  strategies.  Student 
evaluation  will  be  an  integral  element  of  the  analysis  and  will 
confirm  whether  DL  is  the  appropriate  means  of  training  and  will 
contribute  to  analysis  of  overall  program  assessment 
Students  will  be  asked  to  rate  individual  lessons  and  various 
instructional  methodologies,  including  automation  technology, 
printed  materials,  interactivity,  hands-on  training,  and  remediation 
training  on  a  five-point  Likert  Scale  using  "not  helpful"  to  "very 
helpful."  Formative  evaluation  will  be  conducted  throughout  the 
training  with  feedback  being  used  to  ensure  established  goals  are 
met  and,  in  turn,  modify  strategies  where  needed. 

In  addition  to  individual  summative  evaluations,  including 
student  critiques,  attrition  rates,  tests  pass  rates,  program 
success  will  be  analyzed  through  liaison  team  visits  to  specified 
units  approximately  six  months  after  course  graduation.  Combat 


15 


medic  course  graduates  and  supervisors  of  combat  medics  will  be 
interviewed  to  determine  their  opinions  of  successful  learning  of 
recent  combat  medic  course  graduates  assigned  to  the  unit.  The 
feedback  received  here  will  be  significant  to  determining  course 
success.  Modifications  to  training  can  then  be  made  where 
appropriate . 

RESOURCES 

MANPOWER 

Adequate  numbers  of  training  developers,  experienced  in  DL 
training  development  strategies  must  be  available.  Training 
developers  will  modify  existing  training  materials  or  develop  new 
materials  into  effective  distance  learning  design.  A  systems 
approach  to  training  development  as  designed  by  TRADOC  and  various 
distance  learning  concepts  will  be  incorporated  by  the  training 
developers  to  best  train  specific  tasks. 

Distance  education  instructors  will  require  both  new  and 
refined  skills  for  distance  teaching.  These  include:  understanding 
of  the  application  of  the  systems  approach  to  training  and  training 
development;  concepts  of  distance  education;  day-to-day  management 
of  the  distance  education  classroom  and  materials;  ability  to  use 
technology;  effective  presentation  skills.  Instructors  will  need  to 
modify  traditional  classroom  teaching  techniques  to  include 
questioning  strategies,  student  involvement  activities,  appropriate 
lesson  pacing  and  feedback  and  motivating  students. 

Adequate  manpower  resources  are  key  to  the  employment  of  DL 


16 


strategies.  Trained  instructors  must  be  utilized  to  their  fullest 
potential. Many  instructors  are  not  prepared  for  instruction  in 
the  classroom  and  certainly  not  for  DL  training  strategies.  The 
"talking  head"  will  prove  unsuccessful  at  best  and  will  easily  lead 
to  the  downfall  of  DL  training  strategies.^®  Manpower  staffing 
standards  must  be  revised  by  TRADOC  and  the  Medical  Command  to 
adequately  identify  instructor  and  training  developer  resources  in 
the  DL  arena. 

In  addition  to  proper  utilization  of  trained  instructors, 
technology  specialists/site  facilitators  must  be  readily  available 
to  operate  and  perform  preventive  maintenance  on  highly  technical 
equipment.^’  Many  students  could  suffer  set  backs  and  dollars  could 
be  wasted  while  waiting  for  maintenance  and  work  orders  to  be 
processed  and  prioritized.  The  concept  of  technology  specialists/ 
site  facilitators  in  the  classroom  is  a  new  concept  in  combat  medic 
training.  The  technology  specialists/site  facilitators  will  be 
highly  skilled  and  will  maintain  and  coordinate  the  use  of 
technology.  With  1800  combat  medic  students  in  various  classes  in 
a  given  day,  site  facilitators  must  be  efficient  and  able  to 
identify  and  solve  automation  problems  and  provide  other  technical 
assistance.  They  must  ensure  that  the  system  is  operative. 

FUNDING 

Funding  for  initial  DL  development  of  combat  medic  training  is 
provided  through  TRADOC.  It  is  a  comprehensive,  multi-phased 
approach  that  will  encompass  all  aspects  of  DL  training  fiscal 


17 


requirements.  Revisions  and  redesign  in  the  out  years  will  be 
funded  by  MEDCOM  and  AMEDDC&S.  Requirements  will  be  clearly  and 
comprehensively  identified  to  maintain  up-to-date  technology  and 
combat  medic  technical  performance  and  competency. 

RISK  ASSESSMENT 

The  risk  assessment  level  is  low.  The  benefits  of  providing 
standardized  training  to  combat  medics  in  remote  areas  provide  no 
risks.  The  focus  on  student  learning  processes  in  DL,  feedback  to 
the  student/  and  interaction  among  students  and  between  students  and 
teacher  must  be  continually  supported.  Many  civilian  programs,  both 
foreign  and  domestic,  experience  high  drop  out  rates. Though 
military  students  do  not  have  the  luxury  of  dropping  out  at  will, 
the  reasons  for  dropping  out  of  DL-oriented  training  will  plague 
combat  medics  as  well  if  appropriate  steps  are  not  taken  in  the 
training  development  and  instructor  training  processes.  Reasons  for 
drop  out  include  learner  isolation,  which  becomes  more  evident  with 
the  lack  of  feedback.  Students  "needs  must  be  continually  supported 
throughout  the  learning  experience. .. .The  success  of  any  distance 
education  system  is  primarily  dependent  on  the  correct  mix  of  human 
factors  that  support ... learner  needs. 

Instructor  training  in  DL  strategies  is  mandatory  for  success 
and  results  in  a  high  risk  if  not  considered  in  the  strategic 
planning  process.  The  risks  become  exacerbated  when  initial 
training  is  conducted  and  instructors  are  then  left  to  continue  on 
their  own.  To  minimize  the  risks,  instructors  should  be  provided 


18 


opportunities  for  seminars  and  access  to  electronic  resources^®  that 
provide  continued  training  and  exchange  of  ideas  among  other 
distance  training  educators  and  developers.  Seminars  and  workshops 
that  focus  on  new  concepts,  available  automation,  and  experiments  in 
distance  education  may  motivate  and  energize  instructors  and 
training  developers  to  employ  instructional  strategies  that  will  in 
turn  energize  students. 

Further  risks  lie  in  the  selection  of  appropriate  automation 
equipment.  Relying  too  much  on  automation  or  not  properly 
evaluating  and  selecting  technological  strategies  could  prove 
costly.  Time  could  be  wasted  in  training  development  and  instructor 
training  if  selections  are  not  made  systematically.  Risks  are 
multiplied  if  funding  is  not  provided  to  maintain  expensive 
infrastructure  as  well  as  to  have  technically  qualified  personnel 
dedicated  to  maintenance  and  upkeep  of  equipment  and  facilities. 

CONCLUSION 

Continuity  exists  from  the  national  strategy  to  balance  the 
budget  through  the  national  military  strategy  which  mandates 
restructure  of  the  military  and  through  the  Army  Modernization  Plan 
in  support  of  Force  XXI.  The  continuum  is  further  delineated  by  the 
Medical  Command  to  the  AMEDDC&S  which  addresses  plans  and  procedures 
for  distance  education  training  development  in  medical  specialties 
including  combat  medic  training  as  documented  in  A  Plan  for 
Transitioning  Distance  Learning  into  the  Training  Mission  of  the 
Army  Medical  Department .  This  continuum  represents  a  portion  of 


19 


the  overall  strategic  plan  of  the  AMEDD  in  training  initiatives.  All 
areas  of  strategic  planning  must  be  fully  employed  to  meet  the 
thesis  of  conducting  and  sustaining  combat  medics  to  achieve 
deployability  anytime,  anywhere.  A  detailed  plan  of  analysis  with 
stated  objectives  will  support  all  aspects  of  the  training  concepts, 
including  mission/needs/job  analysis,  individual  task 
identification,  medica  selection,  training  development,  student 
evaluation  and  program  assessment.  Resource  requirements  including 
funding  in  the  out  years  for  automation,  personnel,  and  facilities 
as  well  as  manpower  requirements  must  be  thoroughly  researched  and 
funded.  The  risks  involved  encompass  significant  areas  that  could 
potentially  hinder  the  success  of  DL  strategies  not  only  for  combat 
medic  training,  but  for  DL  training  in  the  AMEDDC&S. 

The  DL  concept  of  training  that  is  coming  to  fruition 
throughout  the  Army  is  well  suited  for  combat  medic  training.  When 
thoroughly  and  correctly  analyzed  through  application  of  military 
strategy  documented  by  Lykke,^^  the  DL  process  can  benefit  all 
aspects  of  Army  training  and  particularly  combat  medic  training. 
The  needs  of  the  individual  combat  medic  and  the  needs  of  the  Amy 
leadership  will  be  fulfilled  and  in  turn  contribute  to  Army 
readiness,  the  national  military  strategy,  and  the  national  strategy 
in  general. 


20 


ENDNOTES 


^Donald  M.  Snow  and  Eugene  Brown,  Puzzle  Palaces  and  Foggy 
Bottom  (New  York:  St.  Mark's  Press,  1994),  25-26. 

^Training  and  Doctrine  Command,  "Distance  Learning, "  Third 
Quarter  Fiscal  Year  96  (FY96)  Update.  (Fort  Monroe,  VA:  HQs,  TRADOC, 
1996),  17. 

^Training  and  Doctrine  Command,  Army  Distance  Learning  Plan 
(ADLP)  (Fort  Monroe,  VA:  HQs,  TRADOC,  3  Apr  96),  2-6. 

■’U.S.  Army  Medical  Department  Center  and  School  (AMEDDC&S) , 
A  Plan  for  Integrating  Distance  Learning  Into  the  Mission  of  the 
AMEDD  (Fort  Sam  Houston,  TX:  MEDCOM,  Sep  96),  1-3. 

^Training  and  Doctrine  Command,  "Classroom  XXI,"  Third 
Quarter  Fiscal  Year  96  (FY  96)  Update .  17. 

^Training  and  Doctrine  Command,  Army  Distance  Learning  Plan 
(ADLP) .  iv-v. 

'’TRADOC  Regulation  350-70,  Training  Development .  Management. 
Processes  and  Products.  (Fort  Monroe,  VA;  HQs,  TRADOC,  1995):  ES-7. 

^Training  and  Doctrine  Command,  "Military  Training  Structure 
Review  (MTSR) ,"  Third  Quarter  Fiscal  Year  £6  (FY96)  Update.  20. 

^Training  and  Doctrine  Command,  "Automation/Digitization, " 
Third  Quarter  Fiscal  Year  96  (FY96)  Update.  19. 

’•“Training  and  Doctrine  Command,  Army  Distance  Learning  Plan 
(ADLP) .  iv. 

’’TRADOC  Regulation  350-70,  "Individual  Training  Development,  " 
Training  Development,  Management.  Processes  and  Products  (Fort 
Monroe,  VA;  HQs,  TRADOC,  1995),  IV-1-1  thru  V-5-3. 

’^Darcy  W.  Hardy,  Judy  C.  Ashcroft,  Michael  D.  Abbiatti, 
"Motion  Curricula  and  Non-Motion  Curricula  in  Distance  Education: 
Technology  Selection  Reconsidered, "  Canadian  Journal  of  Educational 
Communication .  (Canada,  1995),  105-106. 

’“U.S.  Army  Medical  Department  Center  and  School,  Letter  of 
Instruction  for  Training  Task  Selection  Board  (Texas:  AMEDDC&S, 
1993),  1-5. 


21 


^^TRADOC  Regulation  350-70,  Training  Development,  Management , 
Processes  and  Products,  VI-3-1  thru  VI-3-10. 

^^Training  and  Doctrine  Command,  "Total  Army  Training  System 
(TATS)  Course,"  Third  Quarter  Fiscal  Year  96  (FY96)  Update,  18. 

^®Darcy  W.  Hardy,  Judy  C.  Ashcroft,  Michael  D.  Abbiatti,  132. 

^’Ibid.,  133. 

^®Training  and  Doctrine  Command,  Army  Distance  Learning  Plan 
iADLPl,  2-10  thru  2-11. 

^^Daniel  Granger  and  Meg  Benke,  "Supporting  Students  At  A 
Distance,"  Adult  Learning  7,  no.  1.  (Sep/Oct  1995):  22. 

^°Amy  Rose,  "Expanding  the  Potential  of  Distance  Education," 
Adult  Learning  7,  no.  1  (Sep/Oct  95) :  pp.  5  and  8. 

^^Daniel  Granger  and  Meg  Benke,  23. 

^^Barry  Willis,  Editor,  Distance  Education:  Strategies  and 
Tools  (Anchorage:  University  of  Alaska,  1994),  99-101. 

^^Barry  Willis,  Editor,  Distance  Education:  A  Practical  Guide 
(New  Jersey:  Educational  Technologies  Publications,  1993),  61. 

^^Daniel  Granger  and  Meg  Benke,  23. 

^^Eric  B.  Allely,  M.D.  "The  Medical  Readiness  Learning 
Initiative  (MERLIN) , "  Workshop  on  Education  and  Training 
Technology,  (Maryland:  NIST,  1996),  64-65. 

2®Barbara  L.  Martin  and  William  J.  Bramble,  "Designing 
Effective  Video  Teletraining  Instruction:  The  Florida  Teletraining 
Project,"  ETR&D  44,  no.l  (1996):  87. 

2’lbid.,  87-88. 

^®Rose,  5  and  8. 

2®Chere  C.  and  Terry  L.  Gibson,  "Lessons  Learned  from  100+ 
Years  of  Distance  Learning,"  Adult  Learning  7,  no.  1  (Sep/Oct  95): 
15. 


^°Marcia  Baird,  "Training  Distance  Education  Instructors: 
Strategies  That  Work,"  Adult  Learning  7,  no.  1  (Sep/Oct  95) :  24-26. 

^^Barbara  L.  Martin  and  William  J.  Bramble,  98. 


22 


^^Training 
Implementation, " 


3-18. 


and  Doctrine  Command,  "Distance  Learning 
Army  Distance  Learning  Plan  (ADLP) .  3-1  thru 


^^Arthur  F.  Lykke,  Jr.,  "Toward  an  Understanding  of  Military 
Strategy,"  Military  Strategy;  Theory  and  Application.  (Carlisle 
Barracks,  PA.:  U.S.  Army  War  College,  1993) ,  3-7. 


23 


BIBLIOGRAPHY 


Allely,  Eric  B.,  M.D.  "The  Medical  Readiness  Learning  Initiative 
(MERLIN),"  Workshop  on  Education  and  Training  Technology. 
Maryland:  NIST,  1996. 

Baird,  Marcia.  "Training  Distance  Education  Instructors: 
Strategies  That  Work,"  Adult  Learning  7,  no.  1  (Sep/Oct 
1995) :  24-26. 

Gibson,  Chere  C.  and  Terry  L.  "Lessons  Learned  from  100+  Years 
of  Distance  Learning,"  Adult  Learning  7,  no.  1  (Sep/Oct 
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Granger,  Daniel  and  Benke,  Meg.  "Suppporting  Students  At  A 
Distance."  Adult  Living  7,  no.  1  (Sep/Oct  1995). 

Hardy,  Darcy  W.,  Ashcroft,  Judy  C.  and  Abbiatti,  Michael  D. 
"Motion  Curricula  and  Non-Motion  Curricula  in  Distance 
Education:  Technology  Selection  Reconsidered."  Canadian 
Journal  of  Educational  Communication  (1995) :  131-135. 

Lykke,  Arthur  F.,  Jr.  Toward  an  Understanding  of  Military 
Strategy".  Military  Strategy:  Theory  and  Application 
Carlisle  Barracks,  PA.:  U.S.  Army  War  College,  1993. 

Martin,  Barbara  L.  and  Bramble,  William  J.  "Designing  Effective 
Video  Teletraining  Instruction:  The  Florida  Teletraining 
Project."  ETR&D  44,  no.  1  (1996):  85-99. 

Rose,  Amy.  "Expanding  the  Potential  of  Distance  Education." 

Adult  Learning  7,  no.l  (Sep/Oct  1995). 

Snow,  Donald  M.  and  Brown,  Eugene.  Puzzle  Palaces  and  Foggy 
Bottoms .  New  York:  St.  Mark's  Press,  1994. 

Willis,  Barry,  Editor.  Distance  Education:  A  Practical  Guide.  New 
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Willis,  Barry,  Editor.  Distance  Education:  Strategies  and  Tools. 
Anchorage:  University  of  Alaska,  1994. 

Training  and  Doctrine  Command  (TRADOC) .  Army  Distance  Learning 
Plan  (ADLP) .  Fort  Monroe,  VA:  TRADOC,  3  Apr  96. 

Training  and  Doctrine  Command,  Third  Quarter  Fiscal  Year  96 
(FY96)  Update .  Fort  Monroe,  VA:  TRADOC,  1996. 


25 


TRADOC  Regulation  350-70,  Training  Development,  Management, 

Processes  and  Products »  Fort  Monroe,  VA:  HQs,  TRADOC,  1995. 


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AMEDD.  Fort  Sam  Houston,  TX:  MEDCOM,  Sep  96. 

U.S.  Army  Medical  Department  Center  and  School  (AMEDDC&S). 

Letter  of  Instruction  for  Training  Task  Selection  Boards 
Fort  Sam  Houston,  TX:  AMEDDC&S,  1993. 


26