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Award Number: W81XWH-05-2-0049
AD
TITLE: Ft. Sam 91 Whiskey Combat Medic Medical Simulation Training Quantitative
Integration Enhancement Program
PRINCIPAL INVESTIGATOR: Paul Phrampus, M.D.
Kimberly Love
CONTRACTING ORGANIZATION: University of Pittsburgh Medical Center
Pittsburgh, PA 15213
REPORT DATE: April 2007
TYPE OF REPORT: Annual
PREPARED FOR: U.S. Army Medical Research and Materiel Command
Fort Detrick, Maryland 21702-5012
DISTRIBUTION STATEMENT: Approved for Public Release;
Distribution Unlimited
The views, opinions and/or findings contained in this report are those of the author(s) and
should not be construed as an official Department of the Army position, policy or decision
unless so designated by other documentation.
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1. REPORT DATE
01-04-2007
2. REPORT TYPE
Annual
3. DATES COVERED
1 Apr 2006 -31 Mar 2007
4. TITLE AND SUBTITLE
5a. CONTRACT NUMBER
Ft. Sam 91 Whiskey Combat Medic Medical Simulation Training Quantitative
Integration Enhancement Program
5b. GRANT NUMBER
W81 XWH-05-2-0049
5c. PROGRAM ELEMENT NUMBER
6. AUTHOR(S)
5d. PROJECT NUMBER
Paul Phrampus, M.D.
Kimberly Love
5e. TASK NUMBER
5f. WORK UNIT NUMBER
Email: [email protected]
7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES)
University of Pittsburgh Medical Center
Pittsburgh, PA 15213
8. PERFORMING ORGANIZATION REPORT
NUMBER
9. SPONSORING / MONITORING AGENCY NAME(S) AND ADDRESS(ES)
U.S. Army Medical Research and Materiel Command
Fort Detrick, Maryland 21702-5012
10. SPONSOR/MONITOR’S ACRONYM(S)
11. SPONSOR/MONITOR’S REPORT
NUMBER(S)
12. DISTRIBUTION / AVAILABILITY STATEMENT
Approved for Public Release; Distribution Unlimited
13. SUPPLEMENTARY NOTES
14. ABSTRACT
This document includes the primary accomplishments for the reporting period, 4/1/05 - 3/31/06. The primary
accomplishments during this period include (1)No cost extension 9/10/05; (2) initiated critical review to provide a best-value
solution for DCMT research requirements; (3) completed initial SIMS configuration planning to meet DCMT requirements.
15. SUBJECT TERMS
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17. LIMITATION
OF ABSTRACT
18. NUMBER
OF PAGES
19a. NAME OF RESPONSIBLE PERSON
USAMRMC
a. REPORT
u
b. ABSTRACT
U
c. THIS PAGE
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27
19b. TELEPHONE NUMBER (include area
code)
Standard Form 298 (Rev. 8-98)
Prescribed by ANSI Std. Z39.18
Table of Contents
Introduction . 6
Body . 7
Key Research Accomplishments . 14
Reportable Outcomes . 15
Conclusions . 16
References . 17
Appendices
18
Introduction
The training of the combat field medic is a critical need of the United States Army. The
91 W program at Fort Sam Houston, Army Medical Department (AMEDD), Department
of Combat Medic Training (DCMT), trains over 7,000 Combat Field Medics per year.
Increased training consolidation in the anned services has put increased demands on the
training program at the DCMT at Fort Sam Houston (FSH). Efficiency and effectiveness
of training are important goals that are continually undergoing evaluation by the
leadership structure of the DCMT.
To ensure a continuous quality improvement implementation strategy, the DCMT
training center leadership requires feedback on the type of training needed by combat
field medic trainees. They are also in need of information concerning how to revise the
curriculum to continually meet a high state of readiness to support the Army's medical
mission. Additionally, it is beneficial to understand how a soldier’s previous
experiences, as well as their participation in various continuing education activities,
influence their performance on critical skills. There is a need for fonnalized assessment
of combat field medic skills retention and investigation of the ideal method of retraining,
taking into account previous experience.
This project intends to introduce the UPMC methodology of simulation and instruction to
the DCMT by utilizing the expertise of the Peter M. Winter Institute for Simulation
Education and Research (WISER).
Body
The following is a description of the project accomplishments for the effort associated
with this award.
Administrative
During the timeframe covered by this report, Dr. John Schaefer, Steve Palumbo, and
Tracee Grubber resigned from their positions at UPMC and WISER. UPMC transitioned
Dr. Paul Phrampus to the role of Principal Investigator to the project. Aaron Yanuzo was
assigned to the project as Program Director.
On September 30, 2005, UPMC submitted a request for a no-cost extension to extend the
project to October 31, 2006.
Logistical Details
Kick-Off Meeting - Fort Sam Houston. The UPMC team met with the DCMT
leadership personnel for a project kick-off at Ft. Sam Houston on July 26 - 27, 2005.
Discussion centered on the changes that have occurred in the 91 W training program since
the original assessment was perfonned in 2003. UPMC received a tour of the facilities.
Operational Review - 9/2005. Tom Dongilli performed an operational review of the
DCMT’s simulation program in September, 2005. During this visit, he defined several
areas that could benefit from WISER expertise, including curriculum development and
documentation management. A system that would allow for an electronic paperwork trail
documenting training is highly desirable.
WISER Meeting - Pittsburgh. LTC David Hernandez, DCMT, and Chris Kwader,
DCMT Simulation Coordinator, attended a tour of the WISER Center in Pittsburgh on
September 26 - 27. After this visit, LTC Hernandez reviewed the information he
received with Col Hastings.
SIMS Software. Beginning development of the SIMS vl.O software took place during
this report period. This software will provide the platform for the programs planned for
deployment at the DCMT.
Operational Review - 2/2006. Dr. Phrampus, Tom Dongilli, and Tracee Gruber met with
the DCMT leadership at FSH on February 20-21, 2006, to conduct an additional review
the operations of the Ft. Sam simulation program. This visit was necessitated due to
changes that took place at the DCMT after the prior operational review.
During this visit, the UPMC team identified several barriers facing DCMT leadership.
As noted during the prior visit, paperwork reduction is still a concern. A key element in
paperwork reduction would be the creation of an effective methodology to track and
evaluate the students’ post-training experiences. However, DCMT leadership expressed
that recent curriculum changes at the DCMT have eliminated the need for additional
UPMC curriculum development.
The following areas could potentially be improved by utilizing UPMC expertise.
■ Workflow improvements through utilization of the SIMS application and
database.
■ Development of academic standards.
■ Implementation of data collection technology.
■ Additional personnel and instructor training.
■ Identification of additional equipment needs
At the end of this reporting period, LTC David Hernandez and COL Patricia Hastings
were in the process of reviewing the suggestions with the intent to provide feedback
towards the next project steps.
Statement of Work
Confirmation of Needs Analysis
Update and confirm findings of WISER 2003 Ft. Sam 91 W “Needs Analysis”.
UPMC Project Directors: John Schaefer, MD, Ron Walls, MD
US Army Principal Investigator: Col Hastings
Timeframe
Task
Results
Week 1
1. On-Site Survey of Ft. Sam
Houston 91 W Combat Medic
Simulation Program to re-assess
current status of medical
simulation program.
2. Incorporate “lessons learned”
from 9 1 W training effectiveness
in terms of reflection of Combat
Medic readiness for roles in
recent conflicts.
An onsite survey was completed
twice during this reporting period.
See “logistic details” section
within the report body for more
information.
Week 2-3
1 . Compile and distribute results of
updated needs analysis.
Completed.
Week 4-6
1 . Project Initiation Workshop
(PIW) to establish a project plan
and assign responsibilities for
WISER team based on
incorporation of updated needs
analysis into an updated proposal.
2. Order Hardware.
Not completed. DCMT
leadership requested a change in
original project scope, which
impacted all deliverables in this
SOW.
Timeframe
Task
Results
Week 7
1 . Equipment received and tested by
WISER.
Not completed. DCMT
leadership requested a change in
original project scope, which
impacted all deliverables in this
SOW.
Work with Ft. Sam and relevant existing consultants to improve the Ft Sam Medical
Simulation Program Management.
UPMC Principal Investigators: Michael Murphy, MD, Thomas Dongilli
US Army Principal Investigator: To Be Named
Timeframe
Task
Result
Week 5-6
1 . Meet with existing program
leadership to review
recommendations of project in terms
of program management and build
consensus for specific
recommendations for changes in
administrative, operational
educational and technological
program support.
2. Install new equipment.
Not completed. DCMT
leadership requested a change
in original project scope,
which impacted all
deliverables in this SOW.
Week 7-9
1 . Develop guidelines and policies for
medical simulation program
management.
2. Identify organizational assets to
support program management.
3. Re-align organizational assets to
support program management plan.
Not completed. DCMT
leadership requested a change
in original project scope,
which impacted all
deliverables in this SOW.
Weeks 10-
12
1 . Develop and implement Instructor
support system of training and
quality assurance.
Not completed. DCMT
leadership requested a change
in original project scope,
which impacted all
deliverables in this SOW.
Create proto-typical simulation laboratory and classroom modules.
UPMC Principal Investigators:
US Army Principal Investigator:
John Schaefer, MD, Ron Walls, MD, Michael
Murphy, MD, Walt Stoy, PhD
To Be Named
Timeframe
Task
Result
Weeks 5-8
1 . Complete specifications of
laboratory-based modules.
2. Complete specification of
classroom-based modules.
Not completed. DCMT
leadership requested a change
in original project scope,
which impacted all
deliverables in this SOW.
Weeks 8-14
1. Develop fonnal goals and objectives
for each of the laboratory and
classroom modules.
2. Develop content for facilitator and
trainee curriculum for each of the
modules.
3. Develop web site content for each of
the modules.
4. Develop simulation scenarios to
support educational goals.
Not completed. DCMT
leadership requested a change
in original project scope,
which impacted all
deliverables in this SOW.
Weeks 15-
21
1 . Educational validation and
evaluation through pilot
implementation.
2. Preparation for full implementation.
Not completed. DCMT
leadership requested a change
in original project scope,
which impacted all
deliverables in this SOW.
Deploy Simulation Information Management System (SIMS).
UPMC Principal Investigator: John Lutz
US Army Principal Investigator: To Be Named
Timeframe
Task
Result
Weeks 6-8
1 . Complete engineering
specification for
reporting/notification
infrastructure.
2. Complete specification for
integration with existing Ft. Sam
Intranet infrastructure.
Not completed. DCMT
leadership requested a change in
original project scope, which
impacted all deliverables in this
SOW.
Timeframe
Task
Result
Weeks 9-13
1 . Complete Ft. Sam Prototype of
WISER SIMS.
Not completed. DCMT
leadership requested a change in
original project scope, which
impacted all deliverables in this
SOW.
Weeks 14-15
1 . Begin installation and
integration of Ft. Sam SIMS.
2. Complete testing Ft. Sam SIMS
at Ft. Sam Houston.
Not completed. DCMT
leadership requested a change in
original project scope, which
impacted all deliverables in this
SOW.
Assess effectiveness of training interventions.
UPMC Principal Investigator:
US Army Principal Investigator:
Walt Stoy PhD, John Schaefer, MD, Ron
Walls, MD, Michael Murphy, MD
To Be Named
Timeframe
Task
Result
Week 14
1. Validate medical simulation
performance evaluation tools that
reflect the specific goals &
objectives of the medical simulation
educational program.
Not completed. DCMT
leadership requested a change
in original project scope, which
impacted all deliverables in
this SOW.
Weeks 15-
20
1 . Utilize the performance evaluation
tools to assess the baseline
effectiveness of the existing
program and to establish
benchmarks for effectiveness at
various stages of training within the
current 16-week program.
Not completed. DCMT
leadership requested a change
in original project scope, which
impacted all deliverables in
this SOW.
Weeks 21-
37
1 . With implementation of the new
medical simulation educational
modules, assess the effectiveness of
the educational intervention through
pre- and post-assessment.
Not completed. DCMT
leadership requested a change
in original project scope, which
impacted all deliverables in
this SOW.
Weeks 38-
40
1 . Assess the net effectiveness of the
new medical simulation educational
interventions with the old system of
simulation training.
Not completed. DCMT
leadership requested a change
in original project scope, which
impacted all deliverables in
this SOW.
Micro-Simulation Learning System Integration
WISER Principal Investigators:
US Army Principal Investigator:
Walt Stoy PhD, Ulrich Christensen MD,
Michael Murphy, MD
To Be Named
Timeframe
Task
Result
Week 2
1 . Obtain from Sophus the goals and
objectives in reference to each
simulation scenario.
Not completed. DCMT
leadership requested a change
in original project scope,
which impacted all
deliverables in this SOW.
Week 3
1 . Link micro simulation scenario
evaluations of individual trainees into
simulation information management
database.
Not completed. DCMT
leadership requested a change
in original project scope,
which impacted all
deliverables in this SOW.
Weeks 15-
20
1. Cross-reference 91 W goals &
objectives to micro simulation
scenario training goals identified in
step one. Develop recommendations
of specific scenarios to utilize and
when as a function of the 91 W
training schedule.
2. Develop schedule of micro simulation
training assignments within the
existing Learning Resource Centers.
Not completed. DCMT
leadership requested a change
in original project scope,
which impacted all
deliverables in this SOW.
Week 37
1 . Implement integrated micro¬
simulation training schedule
recommendations.
Not completed. DCMT
leadership requested a change
in original project scope,
which impacted all
deliverables in this SOW.
Timeframe
Task
Result
Weeks 38-
40
1 . Collect performance data from
completed micro simulation training
assignments to develop benchmark of
perfonnance in this area as a function
of training level and score.
Benchmark would be used to assign
meaningful performance scores to
individual learning outcomes from
the micro simulation software.
2. Develop list of optional
recommended micro simulation
training assignments as a function of
training level And make Learning
Resource Centers available to
trainees for use in “down time
periods” or off-hours for
supplemental learning. Monitor the
use of this.
Not completed. DCMT
leadership requested a change
in original project scope,
which impacted all
deliverables in this SOW.
Preliminary development of 91 W sustainment program.
UPMC Principal Investigator: Walt Stoy PhD, Michael Murphy, MD
US Army Principal Investigator: To Be Named
Timeframe
Task
Result
Week 30-34
1 . Identify key 9 1 W knowledge,
skills, and judgment judged most
likely to have fatigued.
Not completed. DCMT
leadership requested a change in
original project scope, which
impacted all deliverables in this
SOW.
Week 35-40
1 . Identify the extent to which existing
91 W program graduates acquired
proficiency in key evaluation,
procedural and judgment skills
while training at Fort Sam Houston.
From this, develop a list of terminal
training deficiencies.
Not completed. DCMT
leadership requested a change in
original project scope, which
impacted all deliverables in this
SOW.
Key Research Accomplishments
During this report period, the original research program was determined by DCMT staff
to be obsolete due to organizational changes. An alternate research focus remained under
discussion with DCMT leadership staff at the end of this reporting interval.
Reportable Outcomes
During this report period, no final outcomes were developed. The project is in process
and under revision.
Conclusions
Organizational and staffing changes at DCMT resulted in a determination that the
original statement of work and research program no longer met the needs of the DCMT.
The research program underwent critical review to meet the needs of the DCMT
following significant organization and staffing changes. A reviewed statement of work
and research plan is projected.
References
This report did not require the use of documented reference material.
Appendices
Ap. 1 - Kickoff Meeting agenda.
Department of Combat Medic Training
Winter Institute of Simulation, Education, & Research
26-27 July 2005
Tuesday, 26 July 2005 Bldg 1374 Room 120
0800-0830
Introductions
COL Hastings
Dr. J. Schaeffer
Mr. Harvey Magee
0830-0900
91 W Program Overview
COL Hastings
0900-1000
Contract Review / Executive Summary
Mr. Harvey Magee
1000-1015
Break
ALL
1015-1045
Timeline Review Discussion
Dr. J. Schaeffer
1045-1115
Communication Process
Dr. J. Schaeffer
1115-1145
Research Agenda
Dr. J. Schaeffer
1145-1215
Priorities & Concerns
COL Hastings
1215-1230
Open Discussion (O&A)
Mr. Harvey Magee
1230-1330
Lunch
Provided
1330-1530
Tour Simulation Labs
Mr. Chris Kwater
1530-1630
Wrap-up
Mr. Harvey Magee
COL Hastings
Wednesday, 27 July 2005
0800-0900
Observe Training STX
All
STX
Site
0900-1000
Observe Training STX Trauma
All
STX
Site
1000-1015
1000-1100
Break
Observe Training CTPS
All
Room
1100-1200
Exit Brief
COL Hastings
App 2 - Operational Review
Subject
Issue/Concern
Discussion
General
Abundance amount of paperwork
that is created daily and the
amount of time it takes to process
the paperwork.
Resources needed to address
administrative needs and
paperwork.
Storage for the paperwork are
concerns
Conclusions:
• SIMS (Simulation Information Management System) can reduce or eliminate
a significant amount of paperwork. Forms are collected in a centralized
database which allows for instantaneous on demand reporting of results and
automated results that can be emailed to specific administrators and/or
instructors.
• SIMS makes it trivial to see who has completed what. Reports can show what
evaluations, surveys or quizzes need to be completed by individuals and what
they have completed.
• Online quizzes can be automatically scored and reported on.
Subject
Issue/Concern
Discussion
Current
Process
Each trainee uses their hand book, reviews
and practices what they are expected to
leam in the lab. The instructors walk from
station to station and perform general
overviews of trainee performances. No
standardized evaluation tools are currently
used.
By supplying trainees with automated
scenarios that capture performance and
also supply feedback to the trainees will
capture standardize evaluation.
Simulation
Labs
The use of the labs is at the discretion of the
instructors which makes the labs under
utilized
Introduction of process automation and
data management can lead to improved
utilization.
No standardized evaluation tools
Standardized automated scenarios are a
useful tool that capture perfonnance and
provide the ability to give feedback to
the students.
Reservation process for labs is labor
intensive
Automated scheduling of labs will
facilitate ease of use and reduce
resources needed to maintain.
No ability to display curriculum and trainee
feedback
Increase audio visual capabilities in the
Labs, to support SIMS and feedback
capabilities.
Conclusions:
• SIMS training session curriculum is located on a web server and the SimMan
scenarios are programmed into the mannequin. This would allow the trainees
to practice sessions, be objectively evaluated and retrain based on areas that
they are deficient in. This will also allow the program to look at how trainees
are perfonning both individually and as a whole, and adjust the curriculum if
needed. Each station should be standardized and automated to insure
consistency for each trainee.
• Sims allows a semi-automatic scheduling feature for the labs that will improve
utilization and also introduce a data management system. The simplicity of
this process will free personnel for other duties.
Subject
Issue/Concern
Discussion
IT Review
No internet access is available to
the trainees. Trainees and
instructors will need regular
access to the network for online
form completion and course
content.
Col. Hernandez stated that they
were looking into this and what
resources and funds it would
take to make this available.
Identifying the network
connections, band with,
equipment needed and resources
will be needed.
There are three computer labs
with many PC’s in each. Two
labs are underutilized and one lab
is opened to only those who are
having academic issues.
With the installation of SIMS,
and online course content, the
labs can be utilized as a resource
and also a teaching facility.
Current PC’s at Ft. Sam are set up
for SIMS and capabilities
Need to assess current PC’s at
Ft. Sam and identify specs.
PC’s may need upgraded to
meet certain requirements.
Some areas have no PC’s, most
have no projectors and screens.
Need to identify areas that will
need PC’s, projectors and
screens in order to use SIMS
forms and also to display
curriculum. Purchase the PC’s,
projectors and screens for those
areas.
Conclusions:
• SIMS allows you to display the curriculum and performance evaluations in
each room at each station.
• SIMS allows access over the Internet or intranet of course material, surveys
and evaluations to be completed for courses.
• Administrative personnel can review an instructor’s evaluations immediately
upon completion of a class as opposed to the current process which takes
many weeks to review the results.
• By installing SIMS, instructors will be able to review course evaluations
immediately after the session.
Subject
Issue/Concern
Discussion
Situational
Training Exercises
Feedback Process - with only 5-6
instructors that rotate to other
areas fairly often, there is a need
to automate as much of this
process as possible
• Due to the lack of data
collection capabilities, the
stations are not used for
grading.
Paperwork & Process
Improvement
• Once all medics have
rotated thru, the next
problem was paperwork.
Filling it out, reviewing
and storing it. With the
current paper system, more
time needs allotted for
getting current student lists,
rotation of schedules, etc.
SIMS could alleviate all of
this.
Automated Scenarios, resources
utilized
• The Faerdal Instructors
will come in, turn on the
simulators, set the
parameters manually, and
then leave. With the
capability of having the
scenarios automated with
instructor training, this
process could be completed
by the instructor without
the additional personnel
needs.
Conclusions:
• Installing SIMS and automating scenarios with data capture capabilities, each
session could be recorded and documented.
• Trainees and instructors could review performances using SIMS with a
projector and screen to debrief and have the performance data captured into
the database.
• By using SIMS, operations could review trainee performance, trainees could
review their own performance, and data collection for research is now
possible. SIMS enables the absence of storage and processing costs.
Subject
Issue/Concern
Discussion
Micro Simulation
Lab
With minimal or no IT support,
having one instructor in the
room spent most of time
addressing PC related issues
(not logging in, card won’t
work, lost students, etc...). This
frustrates the trainees who were
ready to proceed.
• Increase the instructors to
two, or have IT or another
instructor be there for the
first 20 minutes of the
course.
• SIMS can support this by
having a “Help” section for
this station.
Having no performance
assessment for trainees or
customized feedback.
• There is no evaluation for
grading at this station. There
is no ability to link the
trainees’ performance data in
the Micro Sim lab with any
of their performance data on
the patient simulators,
didactic quizzes, etc.
Increase the utilization of the lab
and also produce tools for
documentation and feedback.
• Automate as much of a
course as possible. Install
support aides for trainees and
course content.
Conclusions:
• Implementation of an assistance plan for each station consisting of tip sheets,
diagrams etc. . . This should be done for both trainees and facilitators and put
online so it is always available.
• SIMS provides post session surveys and tests.
• SIMS will increase the utilization of the labs. From course content to survey
and evaluation completion.
Subject
Issue/Concern
Discussion
Operations
No automated scenarios with data
capture and feedback capabilities.
There are no official processes for
facilitators and curriculum developers
to request and specify what type of
• First phase would be to
automate existing
scenarios and program data
collection and feedback
capabilities.
scenarios and the logistics of each.
• Then train instructors on
how to run scenarios based
on these improvements.
Lack of detailed training by instructors
to program and teach how to use
SimMan software 2.3 / 3.0. Current
programming is at a 1 .4 version level
of utilization. This is very time
consuming and difficult to use by the
end users.
• Training the Laerdal
instructors on
programming with the 2.3
version or higher and use
the forms to assist them as
well as program all
existing sessions. Then we
could move on to other
requests.
Pre-course check lists, equipment
inventory and repairs.
• Install / create online forms
for instructors to use that
will guide them on room
set up, repairs and
maintenance. Automate an
equipment management
program.
Lack of feedback or slow process to
the operations team, pertaining to
course evaluations.
• The operations team may
never see the evaluations
due to them going to the
curriculum team.
Conclusions:
• The majority of the issues that are related to operations revolve around processes
and training. By automating where applicable, and training those who will be
using and teaching others SIMS and the administrative processes around SIMS.
• Recommendation for long tenn effectiveness would be to have each instructor (6)
take the two day train the trainers’ course, or it can be taught on site.
• SIMS would allow the team to review any course evaluations and specifically
evaluations related to equipment.
• We have created forms that assist the scenario programmers and guide them to
completion. We would need to implement these forms there. This would help the
programmers and also help guide the instructor who is requesting the scenario.
By placing these forms online, all instructors will have access. This will also
enable the scenarios to be in a central location on the intranet. Loading scenarios
on 142 simulators can take a while.
Subject
Issue/Concern
Discussion
Bearing Point
Slow process for team to receive
feedback on instructor
performance
• Work with Bearing Point
and automate surveys and
course evaluations. Teach
the team how to utilize
SIMS for form review.
Evaluation process for instructors
too labor some and time
consuming
• We can actually decrease
processing time by
automating forms and
having them enter into the
SIMS database. This will
also help with the labor
considerations needed
currently to complete these
tasks.
3 labs to use, but only one being
used as a learning resource center
• There is a responsibility for
running the LRC (Learning
Resource Center). Only one
lab is used, the other two
are closed
Conclusions:
• By automating the forms, and training the Bearing Point Staff, you will be
able to improve processes and reduce the time it will take to identify an
instructor that needs assistance and should spend some time in the Cadre
Development Center.
• SIMS can improve this process by allowing the CDC to view instructor
performances immediately after a course. CDC will be better equipped to
evaluate instructors, look at trainee perfonnances, and also compare to others
by the use of tools through SIMS.
• By implementing SIMS, that will open the other labs for curriculum access,
evaluations, fill out surveys, etc. . . The thought is to be able to remediate
trainees anywhere and also utilize the facility.
Subject
Issue/Concern
Discussion
Course Content
Students do not have access to
PCs
• PC labs opening and
resource centers need to
work in conjunction to one
another.
Course material is located in large
books
• They also have the need
for sustainment training.
They do a lot of distance
training.
Paperwork process is too
complicated and to labor intense
• Once a student completes
a test, it is then shipped to
the Academic Center. At
the center, the data is
entered and the test is then
placed in storage. With
the large books, the
logistics of entering data
from tests, storage and
admin fees, all can be
reduced by using SIMS
and converting to online
curriculum.
Lack of communication and time
to instructors when curriculum
changes do occur
• SIMS will give the ability
to have the course material
online and will allow the
changes to be immediate
and system wide. With an
automated notification
system to the instructors.
Conclusions:
• SIMS course material is online and available to all trainees which will
reduce the amount of material needed by the trainees.
• SIMS enables the instructor to access and display course content
anywhere.
Subject
Issue/Concern
Discussion
EMT All Skills
Prep Stations
Lack of automated stations and
performance assessment. Not all
trainees receive feedback on
performances.
• The stations are designed
for the medics to practice
for their national registry
exam. There is little or no
performance feedback in
these sessions. There are
minimal or no feedback to
trainees with no data being
collected.
Conclusions:
• SIMS allows the trainees to rotate through the stations, but also have the
instructors mock testing at a few stations, supply feedback and send the
trainees back to the stations where they tested below competence.
• Having SIMS automated scenarios programmed and loaded on each
simulator, the process revision would make the station an exceptional
experience.
General Conclusion:
The 91 W CMTP depends heavily on the use of medical simulation. There is a significant
gap in the use of simulation and assessment. All forms are completed and assessments
are done manually. Most skills stations are being completed with minimal or no
evaluation and feedback to the trainees. Most facilitators that I spoke with would like to
have a more “automated” process. All trainees are evaluated completely by the judgment
of the facilitators. After the 03 visit we had focused on what systems and features we
could implement there. In my follow up visit a few weeks ago, it was very clear to me
that we needed to pull back on the technology push and start small and simple. There are
a number of basic foundation issues that we could address and use as building blocks for
the future efforts.
Key barriers exist at the program. Currently having a high turn over of facilitators, lack
of assessment tools, high man hours to process paperwork and generate reports. Without
the automation of an operational infrastructure, this will only get worse as the 91 W
program will be increasing by 50% with the addition of the navy and air force trainees.
The program has many areas that medical simulation could be used in, but have run into
barriers to use. There are no automated scenarios for instructors to run and no centralized
data base for simulation exercises to be entered into. All paperwork is entered manually
and some never get entered. By supplying this facility with an infrastructure of SIMS,
and automating some of their processes, we should be able to show a drastic
improvement in the areas we address. Items like a centralized calendar and requesting
system, automated fonns for facilitators and trainees, the ability to link fonns (surveys) to
performances, simulation scenarios that actually have the ability to grade trainees,
feedback mechanisms that trainees, facilitators, and operational management can use to
assess / improve the processes.
There are no immediate plans to increase the number of instructors with the program.
With that being said, the need to decrease the amount of man hours processing paper
work, automating systems for instructors, and supplying the tools needed to upgrade the
facility to run SIMS is a must.
We have a unique opportunity at the 91 W CMTP. With a solution of SIMS, you will
improve the processes, decrease labor requirements, and introduce simulation into other
areas that they currently can not use it in and better train / assess the medics and
facilitators. We will be able to improve the system, efficiency, costs to train, and
utilization of tools and facilities.
App. 3 - Kick-off Presentation
UPMC
Univeisily of Pittsburgh
Medical Center
91 W Whiskey / Medical Simulation
Training