Page 49 - JSOM Spring 2025

[The MMO] is an officer first and foremost . . . within that negative outcomes. For example, a cohort study conducted by
realm is the mentorship and development of your sub- Jones et al. (2008) examined the psychological health out-
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ordinate . . . and understanding that the United States comes of deployed medical NCOs compared to other military
government is going to ask you to do a lot more with lim- personnel and found that when compared to their peers, med-
ited resources and capabilities. There’s more ownership ical NCOs were more likely to express negative sentiments re-
on developing your medics or mid-level medical provid- garding cohesion and leadership. Thus, it is essential that the
ers to be able to pick up that slack. MMO and NCO have a positive working relationship, par-
ticularly as the NCO may not necessarily have support from
Reciprocally, the participants also highlighted the signifi- other members of the formation.
cant value in mentorship provided by NCOs to early-career
MMOs. “You have junior medical officers who are . . . lacking Given the significant effects of group cohesion on both psy-
operational experience . . . seasoned NCOs can come in there chological health and unit effectiveness, it is crucial to equip
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and fill that gap and mentor these young military medical of- early career MMOs proactively at the start of their careers
ficers.” (Focus Group) Another participant expanded on this with the skills identified in our study. As dissatisfaction with
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idea, saying, “NCOs . . . have a lot of valuable lessons to teach leadership is often reported alongside poor group cohesion,
[MMOs] in terms of leadership, mentoring their juniors, and implementing strategies that promote open communication,
showcasing their capabilities…We can bridge that gap and es- trust, and mentorship could enhance NCO satisfaction within
tablish long-lasting and enduring relationships with Military the MMO-NCO dynamic. A three-year longitudinal study by
Medical Officers.” (Focus Group) Kim and Yang (2020) demonstrated that the Group Cohesion
Scale can effectively measure and enhance cohesion within
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Discussion medical school cohorts. This tool gauges the strength of re-
lationships and the commitment among group members to-
Our study identified three themes revealing how participants ward their collective goals. Integrating the Group Cohesion
established and maintained a successful MMO-NCO working Scale into simulation-based training for military medical
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relationship: 1) open communication; 2) trust in training; and students—already proven to boost readiness among military
3) mutual mentorship. The three identified themes are inter- medical students for deployed environments 31–34 —could be an
dependent: communication enhances trust, which, in turn, effective strategy to enhance military medical training. During
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strengthens the transparency necessary for effective mentor- these simulations, the medical student designated as the MMO
ship. These elements create a self-reinforcing cycle that bol- would distribute the Group Cohesion Scale to team members
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sters teams’ relational and operational strengths. Educating after completing a group task, sparking real-time discussion
military medical students and early career MMOs about the and feedback on team dynamics and cohesion. The MMO
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importance of this relationship may inspire them to develop would then utilize this feedback to pinpoint areas of concern
positive working relationships with medical NCOs through- and initiate strategies to improve cohesion. Following the ex-
out their careers that will enhance force readiness. ercise, the MMO would receive an evaluation of their perfor-
mance as a team leader delivered by an experienced faculty
Communication is widely accepted across the field of medicine member through a standardized rating system.
as a fundamental “soft skill” essential for interpersonal inter-
actions, which our participants confirmed. As described by the Notably, our participants from the special operations commu-
ACGME (Accreditation Council for Graduate Medical Educa- nity overwhelmingly shared positive interactions with MMOs,
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tion), communication skills are critical for fostering transpar- attributing their success to specific “best practices,” including
ent and open exchanges between healthcare professionals and thorough briefings by the Commanding Officer (CO) about
patients, which is foundational for building trust and effective the capabilities of NCOs, which promoted trust and proac-
collaboration. Additionally, the ACGME details leadership tive, dedicated mentorship from MMOs. The participants sug-
skills within the Interpersonal and Communication Skills com- gested that these strategies be rooted in the specialized hiring,
petency, requiring residents and physicians to act effectively in selection, and onboarding processes characteristic of special
consultative roles and lead healthcare teams. In the structured operations, which emphasize traits like grit, resilience, and
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progression of graduate medical education (GME), which ex- adaptability, essential for mission-specific demands. This ap-
pects resident physicians to increasingly assume teaching roles proach not only facilitates a baseline of trust but also ensures
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and guide less experienced peers, mentorship is an integral part that MMOs are well-informed about their team’s competen-
of leadership responsibilities. Implementing structured interpro- cies before they work together, in contrast with the more vari-
fessional mentorship programs that familiarize medical students able experiences reported by participants from conventional
with the roles and responsibilities of enlisted medical personnel, communities where such practices were not employed.
while also enhancing their skills in mentorship and leadership,
is one potential method for addressing this need. Our findings Future research might systematically compare and evaluate the
regarding communication, mentorship, and trust align with this onboarding and integration processes of MMOs across various
framework, with the participants placing significant value on military branches and units. This research could specifically fo-
the teaching acumen and mentorship commitment of their phy- cus on how structured onboarding processes influence the es-
sician leaders, and reporting that effective mentorship contrib- tablishment of trust and the effectiveness of the MMO-NCO
utes to improved patient care and healthcare delivery outcomes. dynamic. By examining these differences, the research could pro-
Learning these skills in medical school, therefore, lays a key vide evidence-based recommendations for standardizing aspects
foundation for future leadership in the field as MMOs. of the onboarding process as feasible, potentially enhancing
the initial trust and subsequent collaboration between MMOs
In our review of existing research, it was revealed that neglect- and NCOs. This approach would not only bridge the gap in
ing the key themes identified in our study can have significant current practices, but also optimize the readiness and efficiency

Interprofessional Dynamics in Military Medicine | 47