Military medicine
-
Musculoskeletal injuries (MSKIs) among active duty soldiers result in more than 10 million limited duty days each year and account for more than 70% of the medically nondeployable population. Overuse injuries in lower limbs from running, foot marching long distances with heavy loads, and lifting heavy objects are the most common types of injuries in the military. Physical training and rehabilitation exercises for greater resiliency through aerobic, muscle strength, endurance, and agility conditioning programs can prevent or reduce the effects of MSKIs if Soldiers adhere to proper biomechanics and training techniques. We are introducing a three-dimensional (3D) camera-based platform for Optical Screening and Conditioning for Injury Resilience (OSCIR) that is designed to identify and correct high-risk movement patterns based on quantifiable biomechanical measurements in clinical or field settings. Our goal is to improve resilience to MSKI by offering greater access to quality of movement skills in warfighters through an autonomous device that can be used in Sports Medicine and Reconditioning Team (SMART) clinics and High-Intensity Tactical Training (HITT) sites. ⋯ Our study describes the integration process for a 3D camera-based clinical system for MSKI conditioning and rehabilitation. The impact of our system will enable key stakeholders in the military to manage MSKIs in warfighters by automating key assessment and rehabilitation test batteries; making tests more readily accessible, and interpretations more accurate by providing objective biomechanical measures. OSCIR is undergoing turn-key design features to serve as a screening tool for warfighters to readily assess susceptibility to MSKI or as a training platform to help guide exercise techniques to achieve resiliency against future injuries.
-
The condition of trauma patients and the urgent need for timely resuscitation present unique challenges to trauma teams. These difficulties are exacerbated for military trauma teams in combat environments. Consequently, there is a need for continued improvement of nontechnical skills (NTS) training for trauma teams. However, current approaches to NTS assessment rely on subjective ratings, which can introduce bias. Accordingly, objective methods of NTS evaluation are needed. Eye-tracking (ET) methods have been applied to studying communication, situation awareness, and leadership in many health care settings, and could be applied to studying physicians' NTS during trauma situations. In this study, we aimed to assess the relationship between trauma team leaders' objective gaze patterns and subjective expert NTS ratings during patient care simulations. ⋯ This study utilized a mixed methods approach to assess trauma team leaders' NTS in simulated acute care trauma simulations. Our results provide several objective insights into trauma team leaders' NTS behaviors during patient care simulations. Such objective insights provide a more comprehensive understanding of NTS behaviors and can be leveraged to guide NTS training of trauma physicians in the future. More studies are needed to apply these methods to capture NTS from a larger sample of teams in both simulated and real trauma environments.
-
Vection is a stationary individual's illusory experience of self-motion. This illusory self-motion is operationally important for aviation, particularly military aviation, since vection is a dramatic example of spatial disorientation (SD), which is an individual's failure to correctly sense the aircraft's position, motion, and/or attitude with respect to the fixed coordinate system of the Earth's surface and its gravitational vertical. Notably, SD is a major cause of fatal aviation mishaps, and the visual system is particularly prone to provoking vection. This article describes the Virtual Reality Vection System (VRVS), which uses computer-controlled virtual reality technology to induce vection under controlled conditions for training, demonstration, testing, and research. ⋯ The VRVS is currently used to research, develop, test, and evaluate mitigation strategies targeting vection-related SD in degraded visual environments. Similarly, the VRVS is supporting research to develop methods to predict individual differences in visually induced motion sickness susceptibilities. The VRVS is currently being integrated with a precision motor-controlled rotating Barany chair for multisensory studies. It should be noted that since the VRVS was developed to support United States Army Aeromedical Research Laboratory projects, it is an Army product representing government intellectual property and may be freely available to other government institutions.
-
Occupational burnout among healthcare workers has continued to climb, impacting workforce well-being, patient safety, and retention of qualified personnel. Burnout in military healthcare workers, who have had the added stress of increased deployments, remains unknown. Although certain leadership styles have been associated with lower rates of burnout, the association between adaptive leadership and burnout in military healthcare has not previously been described. The aim of this study is to examine the role of adaptive leadership in burnout among military healthcare workers following the Coronavirus Disease 2019 (COVID-19) pandemic. ⋯ The findings of burnout in this military healthcare worker population were higher than have previously been described in healthcare workers or other military personnel, and the significant associations between adaptive leadership and burnout suggest the protective role of adaptive leadership in healthcare systems to address burnout. Implementing adaptive leadership training or selecting leaders with more adaptive leadership skills may be beneficial in a health care system where employee burnout is prevalent, especially during periods stressed by adaptive problems. This may be especially important in military healthcare when active duty service obligations preclude attrition in the presence of additional stressors such as deployments and Federal Emergency Management Agency responses. Further research is needed to determine whether this intervention is successful at reducing healthcare burnout.
-
Combat medics who are responsible for the care of injured warfighters face challenges from their reliance on medical alarms that exceed the noise levels recommended by the WHO. This is because the elevated noise levels in military facilities, particularly from vehicular units and weaponry, compromise the combat medics' effectiveness and attentiveness to medical alarms. We previously designed a graphical ("configural") display to communicate patients' vital signs and found that when the configural display and traditional numerical display were concurrently presented to participants, it produced the fastest identification of patient vital signs and triggered the fewest number of alarms. This study used eye tracking to assess how participants direct visual attention to and engage with concurrently presented numerical and configural vital sign displays. ⋯ We found that when a patient monitor contains both a configural display and a numerical display, participants look at the configural display. Furthermore, during time-sensitive situations, participants utilize the configural display to provide important information. We suggest this because the configural display integrates the relevant vital signs into one display. These findings provide justification for pursuing integrated vital sign displays to efficiently communicate patient conditions in complex environments. On the battlefield, swift decision-making is essential, as combat medics must minimize the time required to assess and act in critical situations.