Combat & Casualty Care Covers Brooke Army Medical Center Sim Program

combat casualty care

Thomas J. Kai, Simulation Center Coordinator for Brooke Army Medical Center’s Sim Program, sent in this recent copy of Combat & Casualty Care, which highlighted their awesome department! Here is just a small excerpt from the complete article written by Steve Melito, TDM Correspondent, linked below.

San Antonio Military Medical Center (SAMMC) is the Department of Defense’s largest inpatient medical facility. Located at Fort Sam Houston, TX, this certified Level 1 Trauma Center spans 2.1 million square feet and counts 425 beds. As the hospital component of the Brooke Army Medical Center (BAMC), SAMMC has also cared for thousands of servicemembers injured in Operations Iraqi Freedom and Enduring Freedom. In addition to patient care functions, this state-of-the-art facility provides a range of education, training, and research programs. Part of Army Medical Command, the hospital houses a Simulation Center that has received a rare accreditation by the Society for Simulation in Healthcare (SSH) for simulation instruction and research, which Lieutenant Colonel Rhonda Deen, the Medical Director of the SAMMC Simulation Center says “validates the high quality of the medical training at SAMMC.”

An Organizational Resource Today, the SAMMC SIM Center is one of the busiest of 10 facilities supported by the Army’s Central Simulation Committee, and just the second such facility to earn SSH accreditation. The SIM Center works with the U.S. Army Institute of Surgical Research, which operates the Army Burn Center at SAMMC, and supports Forward Surgical Teams who train with tools such as the Burn Navigator, a medical simulator that helps teach non-burn specialists how to make medical decisions regarding patient resuscitation. “The Simulation Center is an organizational resource,” explains Robert V. Coffman, the SIM Center’s Simulation Administrator. In addition to current research programs, the SIM Center evaluates new projects that validate simulation as a viable tool for training and education. The Center also provides support for 35 graduate medical education (GME) programs and subprograms, nine Army and Air Force enlisted training programs, an emergency medical technician refresher course, and annual skills validation training.

Expanded Education, Google Glass, and Hybrid Simulation

Medical simulation is evolving rapidly, and facilities like the SAMMC SIM Center regularly learn of new products with exciting possibilities. At the same time, medical professionals also devise new applications for existing products. “Emerging technologies are great,” Coffman says, “but thinking outside the box using current simulators has so many benefits.” As an example, he cites the work of Dr. Bonnie Haupt at Veterans Affairs Connecticut Healthcare Systems. In a practice dissertation for the Doctorate in Nursing Program at Sacred Heart University, Dr. Haupt provided pre-operative education to veterans who were scheduled to receive coronary artery bypass graft surgeries. Coffman says that Dr. Haupt’s research found that “veterans who participated in simulation education revealed a significant increase in knowledge and satisfaction over traditional teaching methods,” including a reduction in patient anxiety. For Coffman, Dr. Haupt’s study suggests that simulation education is a “valuable tool” not just for training medical professionals, but also for educating patients and their families. “I would love to get SAMMC in for a follow-on study,” he adds. Just as apps for handheld mobile devices help medical trainees to test their knowledge and build critical thinking skills, patients and their families might better understand why specific treatment decisions are made. In addition to this research, Coffman is also optimistic about Google Glass, which he says “will be a huge leg up for training evaluation.” By enabling an evaluator to see what a student is focusing upon, Google Glass can help trainers to provide individualized feedback with regard to technologies such as CT, X-Ray, or ultrasound. In this way, evaluators can share a trainee’s point-of-view and “really get into their mind and see their rationale for patient care,” Coffman says.


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Technologies such as the HC1 headset computer project from Motorola Solutions may also hold possibilities. Powered by voice command and equipped for remote video chats and the display of complex schematics, the HC1 uses Microsoft Windows and can connect via WiFi, Bluetooth, or mobile hot spot. Designed for harsh environments and remote locations, this hands-free mobile computer could also let trainers see what trainees see. Hybrid simulation is also expected to play a major role in medical training. According to Coffman, examples include the prompt birthing simulator, which allows real-time patient interaction with a trained actor or standardized patient (SP) while a simulator recreates the complication of a simulated birth. The cut suit, another hybrid simulation example, involves an SP who acts as if he or she were involved in a traumatic accident. The suit replaces actual injuries that must be treated while a patient is conscious. “This adds the realism that static or even hi-fi manikins lack,” Coffman says.

Thomas also sent in some pictures of his latest moulage! He wrote that “the one with the eye has a small impalement in the inner canthus (a screw). The other is a broken ankle where I used epoxy putty and paint, then applied make-up.” 

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Read the complete Combat & Casualty Care Article here and then check out the BAMC Sim Center Page here!


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