Page 80 - Journal of Special Operations Medicine - Spring 2016

Center. The result was to have organic BN Surgeons and Table 1 Factors Contributing to SOLCUS Success
PAs who could instruct and supervise the 18Ds, with the The pros and cons of teaching ultrasound at the
fellowship cadre providing any additional or advanced operator level were openly discussed. The second-
training as required.
and third-order effects were determined and a plan
for expansion was developed before embarking on
Conclusion the project.
The SOLCUS program was created thanks to a number Expert source material and instructors were used to
of highly motivated and influential people in the right develop and implement to program.
place at the right time. This highly successful “good The curriculum was specifically maintained
idea” is due for a review. Reviewing and learning from and adapted for the 18D scope of practice and
the past experiences increases the possibility of future operational environment.
successes. Table 1 summarizes the factors contributing
to SOLCUS success. Table 2 shows the lessons learned Immediate medic feedback was requested and
and recommended solutions for improvement. received on gaps and improvements to presenting the
material. Beneficial changes were made immediately
As the SOF medical community shifts from many years and presented during the next course.
of working in a mature combat theater to more aus- A process was planned and followed to incrementally
tere operating environments, prolonged field care is the increase the number of ultrasound devices within the
renewed challenge. As we adapt training for this com- units. The training and equipment progression was
plexity, programs like SOLCUS better equip the medic leapfrogged, ensuring the program was not saturated
for the realities and requirements of managing their pa- with devices and untrained medics.
tients. Ultrasound technology in the hands of a medic
is now more relevant and impactful than ever. As ad- The ultrasound education was coordinated with
ditional ultrasound equipment becomes available and is the lifecycle replacement of existing devices. This
fielded, let us discuss this challenge during the upcoming removed the financial burden from the unit and
Special Operations Medical Scientific Assembly in Char- appropriately identified it as an enduring requirement
lotte, North Carolina in May 2016. supplied by the Army.

Table 2 Factors That Can Be Improved to Enhance Future Success
Lessons Learned Recommendations
Keeping the lectures close hold ensured the Present short audio/visual lessons of the material via
information was consistently delivered across each social media. Have a central location that medics can
SFG. However, it severely limited its exposure outside trust and that can be updated regularly for viewing
the classroom and prevented self-paced learning for and downloading. This allows self-paced learning
individual medics motivated above the instruction outside of the regular classroom, thereby increasing
we provided. learning progress inside the classroom.
The initial quality assurance (QA) process was Identify a simplified image-storage system that can be
complex and quickly fell apart when the DoD banned backed up regularly and accessed for archive and QA
universal serial bus (USB) access for Government requirements. This can happen at regular intervals
computers. The backup plan was too complex and during the deployment or immediately afterwards.
easily became overcome by all operational events for
the medics.

Stress early in the training process the importance of Develop standard operating procedures (SOPs) for the
identifying the patient and labeling images for QA and minimum set of patient identification and scanning
later review. indication requirements. Ensure the SOP is simple and
user friendly.
Training the trainers/supervisors together with the Incorporating ultrasound exposure early in the
learners can have adverse impact on the trainer’s skill provider training will significantly improve their
development. The pressure to progress faster than the confidence and proficiency when placed in a
medics became an obstacle for some providers. supervisory roll with the medics. Discussions with the
provider consultants could improve this plan.

64 Journal of Special Operations Medicine Volume 16, Edition 1/Spring 2016