Page 99 - JSOM Summer 2020

highlight the need for the DoD to improve in its methods of Methods
conducting TCCC training.” 5
One author (DG) coordinated and executed a series of physi-
It is noteworthy that the problematic events discussed above cal site visits in a prospective observational study between Sep-
occurred despite the existence of a standardized, JTS-ap- tember 2018 and June 2019.
proved TCCC curriculum since 2013. This underscores the
critical need for an improved oversight system through which Identification of Specific Courses to Be Appraised
the DoD can ensure that the currently approved JTS curricu- The TCCC-MP courses that were proposed for appraisal in
lum is the one used to conduct TCCC courses for the military. this study included any military or civilian training site that
represented itself as teaching TCCC principles to medical
The 2018 DoD Instruction 1322.24 (Medical Readiness Train- personnel. This included courses that were offered through
ing) established TCCC as the DoD standard for battlefield the NAEMT educational infrastructure as well as others that
trauma care and mandated TCCC training for everyone in were not. The primary focus of these course appraisals was
the US military. The same instruction also directs the newly TCCC-MP courses, although one course that did not specif-
12
established Joint Trauma and Education Training Branch of ically claim to be a TCCC-MP qualification but is used by
the Joint Trauma System to develop high-quality, standard- military units to satisfy predeployment TCCC training re-
ized curricula to train US military service members at the ap- quirements for medical personnel was included as well. The
propriate level for their role in treating trauma victims and intent was to do a series of 10 to 12 appraisals, but due to
this effort is now ongoing. This instruction failed, however, limited travel funding, only four appraisals have been accom-
to establish a quality assurance function in the JTS to ensure plished to date. The courses appraised included training sites
that TCCC training is carried out correctly. Individual courses from the Army, Navy, and Air Force.
and instructors may or may not use all of the materials in
the JTS-approved curriculum; they may or may not add con- Overview of Aspects of TCCC Training Courses Appraised
tent that is not part of the JTS curriculum; and they may or The directors of the proposed courses to be appraised were
may not add additional training in the form of simulation, contacted. The course appraiser explained that he would be
hands-on training with moulaged casualties, graded trauma conducting a quality assurance (QA) appraisal of TCCC-MP
lanes, or live-tissue training. courses. Once approval was obtained and an agreed-upon
course date was determined, a physical site visit was conducted
in which the appraiser attended the TCCC course being con-
A Pilot TCCC-MP Training Course Appraisal Effort
As noted above, the JTS recognized the need for an ongoing QA ducted. A standardized appraisal tool/form was utilized to col-
of TCCC courses in 2015. TCCC courses conducted through lect predetermined data elements to include:
the NAEMT educational infrastructure have that organization’s
QA efforts in place to ensure the integrity of the content. Some • Dates and location of the course
TCCC courses taught to DoD units, however, are not con- • The time used to present each topic
ducted through NAEMT, however, and there has been little QA • The fund of instructor TCCC knowledge as assessed by
of these courses. The CoTCCC, therefore, in 2018 implemented his or her presentation and ability to respond to ques-
a program to assess TCCC for Medical Personnel courses to de- tions from the students
termine the extent to which they use (or do not use) the JTS-ap- • Additional instructor messaging beyond that contained
proved criteria for that course and to understand better what in the curriculum
other material is being taught in TCCC courses. • Additional training modalities used in the course

Additional goals of this series of course appraisals were to: Appraisal Conduct
The course appraiser was physically present for the entirety
1. Gain a more accurate understanding of the time actually of all courses evaluated. Descriptive narratives were prepared
required to train all of the material contained in the current and detailed notes of each class session were taken and used
TCCC-MP curriculum; to create individual appraisals for each site/course. In addi-
2. Determine whether TCCC-MP courses conducted appro- tion, information was to be gathered regarding whether or
priate post-course evaluations to ensure that knowl- not the courses appraised were employing the CoTCCC-rec-
edge transfer of the TCCC material had been effectively ommended post-course metrics intended to ensure that TCCC
accomplished; knowledge and skills had been effectively acquired. 22
3. Identify what training modalities are being used to sup-
plement the standardized, JTS-approved 2018 TCCC-MP De-identification of Appraisal Data
curriculum (e.g., part-task trainers, advanced training In order to maintain good rapport with TCCC training sites,
manikins, moulaged simulated casualties, “hyper- realistic” the descriptive data contained in the results section has been
training environments, cadavers or perfused cadavers, deidentified with respect to which course each data set rep-
graded trauma lanes, autologous blood transfusion train- resents. Identified individual course appraisals will, how-
ing, 20,21 live tissue labs, etc.) and how much time was spent ever, be forwarded to each of the course directors for their
in employing these additional training options. consideration.
4. Identify any additional material being taught in the
TCCC-MP courses that was not part of the actual curricu-
lum for later determination of whether the additional ma- Results
terial might be a good addition to the course or whether it A total of 10 TCCC-MP courses that met the inclusion criteria
is was incorrect and/or inappropriate and should therefore were identified. However, only four of the identified courses
be removed. were actually appraised due to the previously mentioned JTS

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