Military medicine
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Emergent clinical care and patient movements through the military evacuation system improves survival. Patient management differs when transporting from the point-of-injury (POI) to the first medical treatment facility (MTF) versus transporting from the Role 2 to the Role 3 MTF secondary to care rendered within the MTF, including surgery and advanced resuscitation. The objective of this study was to describe care provided to patients during theater inter-facility transports and compare with pre-hospital transports (POI to first MTF). ⋯ Inter-facility transports (Role 2 to Role 3) are longer in duration, transport more complex patients, and are staffed by more advanced level provider types compared to transports from POI.
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The U.S. Army fell 25% short of its recruitment goal in 2022 and therefore, increasing the eligibility pool for potential recruits is of interest. Raising the body mass index (BMI) standards for eligibility presents a path to increase the recruitable population; however, there may be additional costs incurred due to attendant health risks that may be present in individuals with higher BMI. ⋯ Potential recruits from Cluster 1 have excessive health risk and may incur substantial cost to the U.S. Army if enlisted. However, potential recruits from Cluster 3 appear to add little risk and offer an opportunity to increase the pool for recruiting.
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Assessing learner performance is a primary focus within simulation-based education in order to prepare students with the knowledge and skills they will need going forward in their careers. In order to properly conduct these assessments of learner performance, faculty must be adequately trained on the scenario, expectations, assessment measures, and debriefing. During Operation Bushmaster, a five-day "deployment" for learners, faculty assess students as they rotate through different leadership roles. The faculty development includes online and in-person training that provides them with an understanding of the scenario; what learners know; the framework used at USU to guide curriculum, development, and assessment; how to assess learners; and how to provide feedback to learners. Research has examined the value of receiving assessment and feedback from a student perspective, but the impact of being the assessor and giving feedback has not been researched from the faculty point of view. The purpose of this study, therefore, was to examine the impact of assessing students in simulation scenarios on faculty's own development as an educator and leader. ⋯ This work describes how even when faculty are brought in for learner assessment, they are taking away lessons and experiences that aid in their own development as an educator as well as a leader. Acting as an assessing faculty for students may allow faculty to reground their own thinking, remain up-to-date on necessary skills, and continually develop their skills as an educator and leader. These findings suggest that some faculty involved in simulation events may also gain knowledge, skills, and experiences that can help with their own development even when the focus is on learners.
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Research and development of military-required innovations are usually funded through the issuance of grants and contracts. The limitations of these funding methods are the a priori specifications and objectives that limit creativity and often do not produce capabilities beyond the desired outcomes or leverage the best ideas and solutions available. This limited engagement of commercial industry to develop military-required innovations usually relies solely on government funding and receipt of proposals from companies whose business model is built on receiving government grants and contracts, with the government owning most of the risks. ⋯ This often under-utilized pathway has several notable strengths such as (1) reduced risks and costs for the military to develop novel capabilities and products; (2) new and novel creative solutions to solve military problems; (3) utilizing a results-oriented approach that funds the successful achievement of acceptance criteria versus funding of potential to achieve; (4) enticing investors by increased competition for a successful product or capability; and (5) delivery of a commercially available, affordable, field-tested, and viable capabilities and products. Prize competitions may be used by any/all federal agencies as authorized by Congressional Public Laws and Federal regulations. The specifics of this pathway for funding pathway and applications for use by medical researchers, developers, and project/program managers are spelled out in the article, along with the regulatory guidance and resources for finding out more about current and past prize competitions.
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Shoulder injuries account for approximately 8% to 24% of all musculoskeletal injuries in the military. Recently, a change was made to service-specific physical fitness tests. Knowledge of relative shoulder labral injury rates before and after this change would help guide future directions and preventive strategies. However, we found no previous literature evaluating the rates of labral injury among United States Military branch personnel by enlistment status (enlisted versus officer), gender, age, or race. ⋯ With knowledge of injury patterns in specific military populations, initiatives may be taken to identify at-risk service members with the goal of informing future preventive strategies.