Page 52 - JSOM Fall 2024

requirements was a barrier to further medical sustainment The 70 medical knowledge and procedural skill items were
7
training. This is important because these 18Ds indicated that categorized by a panel of experts. This panel of experts in-
medical skill sustainment training would substantially im- cluded two enlisted special operations medical personnel, an
prove their ability to deliver medical care. 7 active-duty physician assistant, and two active-duty physicians
embedded within SOF unit leadership. Categorization was
Despite the essential role of sustainment training for SOF med- completed in four phases. First, each expert completed the
ics, there is no recent data on the self-perceived sustainment categorization worksheet independently of other panel mem-
training needs of SOF medics. To fill this important gap, and bers. This worksheet included the 70 items and instructions
toward preserving life on the battlefield, the present study was to place the items into whatever categories the expert may de-
designed to survey active SOF medics regarding their self- vise. Second, completed worksheets were distributed among
perceived sustainment training needs and their perceptions of the experts for review. Third, experts then met to determine
how sustainment training could be improved. The survey in- the optimal number and names of categories, and which items
cluded their confidence ratings on 70 specific medical knowl- belonged in each category. Lastly, the finalized consensus cate-
edge and procedural skill items, assembled into 9 categories gorization schema was approved by all panel experts.
by a panel of experts. Participants also indicated whether ad-
ditional training in these areas would make them more profi- The consensus included the following 9 categories (abbrevia-
cient in their role as a SOF medic. Lastly, open-ended inquiries tions in parentheses):
provided opportunities for SOF medics to indicate their most
important areas of training needs, their preferred sustainment 1. Infectious disease (Infect)
training modalities, the best aspects of SOF medic sustainment 2. Anesthesia/Airway (Air)
training, and how SOF medic sustainment training could be 3. Trauma/Resuscitation/Surgical Skills (Trauma)
improved. 4. Environmental (Env)
5. Critical Care (Crit)
Our null hypotheses were that there would be no statisti- 6. Tactical/Administrative (Admin)
cally significant differences in confidence (hypothesis 1) or in 7. Psychiatric/Neurologic (Neuro)
whether additional training would increase proficiency as a 8. Other, but not limited to, including veterinary/dental/minor
SOF medic (hypothesis 2) across 9 categories of established procedures/diagnostic (Other)
medical knowledge and procedural skills expected of a SOF 9. Differential Diagnosis (DiffDiag)
medic.
Table 1 shows that the majority (61%) of items were in one
category, one-third (34%) were in two categories, and 4%
Methods
were in three categories.
The study protocol was approved by the Institutional Review
Board at Naval Medical Center San Diego (NMCSD.2020.0053), The survey also included qualitative open-ended questions re-
with a waiver of informed consent based on anonymous re- garding the state of SOF medic sustainment training, the best
sponding. Manuscript approvals from Public Affairs Officers aspects of SOF sustainment training, how SOF sustainment
were obtained from Naval Special Warfare Command, Navy training can be improved, areas where additional training
Medicine Readiness and Training Command San Diego, and would benefit them the most, and preferred training modali-
the Uniformed Services University of the Health Sciences. ties. The survey also included a space for participants to sound
off with any additional comments or observations they might
Target Population and Recruitment have regarding SOF sustainment training.
The target study population was active SOCMs and Special
Operations Tactical Medics (SOTM). Participants were re- Design and Data Analysis
cruited via email. A pre-formed distribution list of all active This observational study employed a cross-sectional design in
SOCM/SOTM personnel was obtained from unit leadership. that each participant was measured once. Confidence ratings
Potential participants received an invitation email, which em- were analyzed using analysis of variance (ANOVA). Nominal
phasized that participation was strictly voluntary. Further, the needs data were analyzed using McNemar’s tests. Responses
invitation emphasized that study participation and study data from open-ended questions were assessed using thematic analysis
would be kept anonymous, private, and confidential, and it methodology. Quantitative analyses were conducted using SPSS
encouraged participants to be completely honest and candid statistical software (version 23, IBM Inc., Chicago, IL). Quan-
with their responses. Clicking on the email link brought the titative results are expressed as percentages or as mean, stan-
participant to the survey at the Max.gov online survey web- dard deviation (SD), and range values in text, and as mean and
site. Data were collected between 2021 and 2022. standard error of the mean (SEM) in figures. Differences were
considered to be statistically significant at the P<.05 threshold.
Survey Development
The quantitative portion of the survey included the 70 specific Results
medical knowledge and procedural skill items listed in the Ad-
vanced Tactical Paramedic Protocols (10th Edition). Each of Participant Population
these 70 items was queried in two contexts. First, participants A total of 68 SOF medics responded to the invitation. Of
responded on a 1–5 scale (1 = strongly disagree, 5 = strongly these, 57 (84%) sufficiently completed the survey to be in-
agree) to the prompt, “I have confidence in . . .” Second, partic- cluded for statistical analysis (n=57). Participants were
ipants responded either Yes or No to the prompt, “I would be well-divided between SOCM (53%) and SOTM (47%), with
more proficient in my role as a SOF medic if I had additional roughly half (49%) completing initial training within the
training in the application of . . .” prior 4 years. The majority were Special Warfare Operator

50 | JSOM Volume 24, Edition 3 / Fall 2024