Page 51 - JSOM Winter 2025

TABLE 2 TAC MED CELL (BEL Def) Course Structure and Domains
Element Time allocation Purpose
Initial entrance examination 4 hours Basic knowledge in human anatomy and
physiology
Theoretical modules 3 weeks TCCC, PHTLS, AMLS principles and SOPs
Practical modules 3 weeks Dead tissue trainings, trauma patient simulator
(mannekin simulation), clinical scenarios individually or in teams and a large
spectrum of clinical practicals in CASEAC, complex casualty extrication, MASCAL
or amphibious medical incidents
Final Examination 72 hours Certification
PHTLS = prehospital trauma life support; CASEVAC = casualty evacuation; AMLS = advanced medical life support; SOP = standard operating
procedure; MASCAL = mass casualty.

Regarding the mission of the MED PROVIDER, particular Smironov test. The comparison of means for independent
attention was paid to the quality of material preparation, samples was run by the Wilcoxon Rank Sum Test, or Kruskal-
completeness, and safety in execution. Communication with Wallis test if more than three variables. The Spearman, two-
the MED LEADER and other MED PROVIDERS, reactivity tailed, was used for exploring correlations between theoretical/
to MED LEADER requests, quality of reporting and empathy practical results and results from the subdomains. Finally, a
towards the casualty were the measured soft skills. linear regression was performed with the Final Practical Re-
sults as a dependent variable.
Finally, the function of TAC LEADER was evaluated through
quality indicators of situational awareness, safety and secu- The best candidates were defined as scoring one standard devi-
rity rules, planning of tactical actions, and consolidation of ation above the mean in the final practical examination.
the medical evacuation plan proposed by the MED LEADER.
The results were considered significant when P<.05.
Evaluation Tools
The candidates were evaluated on the percentage of correct The study protocol was approved by the institutional office
responses given during the theoretical evaluation and by at for data protection and the Ethics Committee of University
least two evaluators from Tactical Medical Training Cell Ghent and Ghent University Hospital (UZ Gent) and regis-
( TacMed) during the practical examination. For each case tered under number ONZ-2023-0600.
with role players, three main case objectives (one dealing with
the hard skills, one with the individual soft skills, and one with Results
the collective dynamics) were preliminarily defined and spe-
cifically evaluated through a scoring system reportable on a Examination results from 137 candidates for an advanced
percentage scale. Combat Medic certification were collected from January 2021
until December 2022.
Hard skills were evaluated based on medical knowledge and
terminology, clinical expertise, proficiency in medical tech- The mean age of the candidates was 30.30 years (range 21–
niques, familiarity with medical equipment, interpretation of 49 y), with a mean seniority in the army of 8.99 years (range
medical charts, medication administration, and adherence to 1–22 y). Around 2% of the participants were females.
healthcare protocols.
Non-EMT candidates represented 62.8% of the studied pop-
Soft skills were assessed through effective communication, cre- ulation (Figure 1). There were no significant age or seniority
ativity, empathy, problem-solving, critical thinking, adaptabil- differences between the non-EMT and EMT groups.
ity, flexibility, and time management. FIGURE 1 Proportion of studied groups.

Collective dynamics were evaluated by examining role defini-
tion and adherence, behavioral norms, interpersonal relation-
ships, and the effectiveness of information exchange.
Video- or picture-captured material serve as evidence for the
final scoring. At the end, each candidate and team had to re-
spectively identify individual and collective learning points.

Statistical Analysis
The aims of the statistical analysis were to systematically de- EMT = emergency medicine technician.
scribe all populations/outcomes, explore the correlations be- In the total group, 71.5% of the candidates succeeded at the fi-
tween parameters, and to calculate the regression model for nal test and 9.5% failed. Nineteen percent of the total group did
predicting best end scores. not complete the entire course or final certification examination.

Biostatistical analyses were done with IBM SPSS Statistics Even if not statistically significant, non-EMTs and older candi-
Version 29.0.1.0 (171) (Licence Gent University, Belgium). dates were found more resilient with regards to the non-com-
Normality of the data was controlled by the Kolmogorov- pletion of the course.

Belgian Education System of Combat Medics | 49