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budget (materials). The full cost of this training did not exceed among service members has been focused on changing an indi-
$780 (existing unit resources). vidual’s mindset about treatment. This is in contrast to chang-
ing the intervention to meet the cultural needs and leverage the
Limitations strengths of individuals and their units. Strategies that have
This training was conducted with a small, highly specialized focused on changing negative perceptions or views of men-
unit. Larger units would require process alterations for effec- tal health services have had only mild success. Embracing the
tive orchestration, specifically additional logistical support performance mindset of operators as a means of overcoming
(SMEs aiding in preparations), and additional time to ensure stigma and barriers to psychological health integration pres-
each trainee has an opportunity to engage and receive feed- ents opportunities to close these critical gaps. SIT-NORCAL
back in the Adaptive Environmental Simulation. Limits on should be more fully explored to determine scope and reach.
the study’s generalizability include the use with a single ca-
reer field, lack of gender representation, and small sample References
size. Use of HRV biofeedback during the AES was valuable. 1. Robson S, Manacapilli T. Enhancing performance under stress:
Further study should incorporate more rigorous psychophys- Stress inoculation training for battlefield airmen. Santa Monica,
iological measurement during the simulations. Additionally, CA: Rand Corporation; 2014.
future studies should incorporate the most recent versions of 2. Rizzo A, Pair J, Graap K, et al. A virtual reality exposure therapy
application for Iraq War military personnel with posttraumatic
the TOPS (version 3) and the Wilder Collaboration Factors stress disorder: From training to toy to treatment. IOS Press.
rd
Inventory (3 edition). 2006;(6):235–247.
3. Stetz MC, Long CP, Schober WV, et al. Stress assessment and
management while medics take care of the VR wounded. Ann
Conclusion Rev CyberTher Telemed. 2007;5:165–171.
4. Wiederhold MD, Wiederhold BK. Virtual reality training trans-
Initiation of the Core Training processes and content demon- fer: A DARWARS study. Physiological monitoring during sim-
strated high feasibility and acceptance among this high- ulation training and testing. San Diego. CA: The Virtual Reality
intensity/high-risk occupational group. Furthermore, the Medical Center; 2006.
training acted as an evidence-based/evidence-driven ‘engine’ 5. Wiederhold MD, Wiederhold BK. Training combat medics using
that generated data points on areas for growth and further VR. Cyberpsychol Behav. 2004;7(3).
training opportunities, as well as areas of strength for the unit. 6. Barwood MJ, Dalzell J, Datta AK, et al. Breath-hold performance
Detailed feedback and recommendations based on the data during cold water immersion: effects of psychological skills train-
ing. Aviat Space Environ Med. 2006;77(11):1136–1142.
generated by the unit (as a whole) were given to the unit to 7. Stetz MC, Long CP, Wiederhold BK, et al. Combat scenarios and
develop further training, and to individuals who participated relaxation training to harden medics against stress. J Cyberther
in the training for their own use. Rehabil. 2008;1(3):239–247.
8. Stetz MC, Wildzunas RM, Wiederhold BK, et al. The usefulness
The most common requests were for a full (third) day dedi- of virtual reality stress inoculation training for military medical
cated solely to Mental Agility/Mental Flexibility training and females: a pilot study. Annu Rev CyberTher Telemed. 2006;4:
51–58.
additional Simulation training. Opportunities for sharing 9. Driskell JE, Johnston JH, Salas E. Does stress training generalize
Catalytics and Simulations between units to expand training to novel settings? Hum Factors. 2001;43(1):99–110.
repertoire and intermittent repetition following Core Training 10. McClernon CK, et al. Stress training improves performance
were evident. They are now being pursued to enhance skill during a stressful flight. Hum Factors 2011;53(3):207–218.
maintenance. Further, it is highly likely nonpsychologists 11. Hourani L. Testing and evaluation of a predeployment stress in-
(e.g., SMEs, unit medics) could be trained to implement SIT- oculation training program (PreSTINT). Research Triangle Insti-
NORCAL with consultation from a trained psychologist. Pro- tute Durham United States. 1 July 2016. https://apps.dtic.mil/sti
/citations/AD1024710. Accessed 6 June 2021.
cesses, risks, and benefits should be fully explored. 12. Rocklein Kemplin K, Paun O, Godbee DC, Brandon JW. Resil-
ience and suicide in Special Operations Forces: state of the science
Core Training could be easily expanded to support more com- via integrative review. J Spec Oper Med. 2019;19(2):57–66.
plex skills or target other areas of health and human perfor- 13. Mattessich P, Murray-Close M, Monsey B. Wilder Collaboration
mance. Additional career field and unit-specific training targets Factors Inventory. 2001. https://ktdrr.org/ktstrategies/ktstrategies
_search.cgi?location=sr&sel_1=187. Accessed 6 June 2021.
could be identified via evidence-based community engagement 14. Thomas PR, Murphy SM, Hardy L. Test of performance strate-
and assessment processes such as the Community Based Blue- gies: Development and preliminary validation of a comprehensive
27
print (CBB). The CBB process aids in the construction of measure of athletes’ psychological skills. J Sports Sci. 1999;17(9):
a precision targeting system by identifying ‘demand signals’ 697–711.
(gaps in knowledge, skill, ability, training and performance re- 15. Jackson S, Baity MR, Bobb K, et al. Stress inoculation training
source availability) within a specific occupation/unit, tied to outcomes among veterans with PTSD and TBI. Psychol Trauma.
physical and psychological requirements, in order to optimize 2019;11(8):842–850.
performance on occupational core tasks. Demand signals gen- 16. Attkisson CC, Zwick R. The client satisfaction questionnaire.
Psychometric properties and correlations with service utilization
erated by the CBB analysis of a specific occupational group and psychotherapy outcome. Eval Program Plann. 1982;5(3):
would provide critical data, triggering implementation of SIT, 233–237.
refinement of specific modules and/or formulation of comple- 17. Goswami U. Principles of learning, implications for teaching: A
mentary training modules to meet the identified demand. cognitive neuroscience perspective. J Philos Educ. 2008;42(3–4):
381–399.
18. Knox R. Mind, brain, and education: A transdisciplinary field.
There is substantial opportunity to overcome barriers by shift- Mind Brain Educ. 2016;10(1):4–9.
ing focus to a cultural integration of psychological services 19. Mayer RE. Applying the science of learning. Boston, MA: Pear-
and paradigms that embrace the skills and values of high-risk/ son/Allyn & Bacon; 2011.
high-intensity career fields. Traditionally, efforts to reduce 20. Mayer RE, Alexander PA. Handbook of research on learning and
stigma or improve mental health perception and care-seeking instruction. New York, NY: Routledge; 2017.
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