JOINT BASE SAN ANTONIO-FORT SAM HOUSTON, Texas –
The “patient” had fallen to the ground after losing consciousness. Emergency Medical Technicians were called to the scene. Upon arriving, the EMTs quickly assess the patient’s breathing and pulse while checking the patient’s body for injuries. Finding no pulse, the EMTs conduct life-saving interventions to revive and stabilize the patient, then transport the patient to the hospital.
Emergency medical technician, or EMT, training is an integral part of the Department of Combat Medic Training program at the Medical Education and Training Campus, or METC.
Located at Joint Base San Antonio-Fort Sam Houston, DCMT trains its students to effectively treat pre-hospital patients during emergency and non-emergency conditions in a variety of operational and clinical environments.
Students spend the first seven weeks in the 16-week program learning basic EMT skills and must pass the National Registry of Emergency Medical Technicians exam in order to move on to the next phase in the program.
Normally, students enrolled in an EMT program will ride along in an ambulance as well as conduct clinical rotations as part of their training.
Because of the large number of students that DCMT trains – between 300 and 400 per class – it is not feasible to deliver this type of experience. Instead, training consisted of classroom lecture followed by simulated patient interactions – hands-on scenarios using partial manikins or classmates as “patients”, usually positioned on the floor or tables in an otherwise uninspiring lab space.
“The training labs were beginning to run their course,” said Chris Kwader, DCMT simulation supervisor. “They were becoming boring and stale, and didn’t provide students with any sort of realist patient encounter.”
EMT simulation staff Sara Miller, Mario Ramon and Jeffrey Schuld realized this and took matters into their own hands.
“Through the creativity of the DCMT EMT simulation staff, five different lab settings were designed to not only increase the students’ situational awareness, but also to expose students to real world patient encounters while in the learning environment,” Kwader explained.
Miller, who is also an EMT instructor and supervises two of the sim labs, said that because her labs were the first to be finished, there was a brief overlap in the beginning with some students having used both the old and new labs.
“The students like the interaction better in the new labs,” she stated. “The settings make it more realistic for them which they like because they feel like they’re interacting more with the patient.”
The “patients” are hi-fidelity Human Patient Simulators, or manikins, which are placed throughout the labs in five separate simulation rooms.
Each lab room is constructed to resemble a different environment, complete with props and settings designed to give the space a realistic feel. The environments include a business office, a park and bodega, a warehouse, a residence, and a hospital emergency room.
The “patient” might have suffered a traumatic injury or experienced a medical emergency. Students will enter one of the simulation rooms and assess their patient according to the given scenario. The HPS’s can be programmed to present vital signs, symptoms, and even talk, making the patient interaction that more realistic.
Spc. Eric Blanchard, a DCMT student who just completed a training scenario in the simulated residential lab, said the training was a bit nerve wracking.
“It’s definitely different performing a live hands-on analysis than it is in the classroom just discussing it,” he said, adding that it’s good to get out there before working with real people to get more comfortable going through the motions.
“Even though it was a little nerve wracking I enjoyed it and I hope to do more and get even better,” Blanchard added.
Blanchard’s classmate, Pvt. Joshua Becker said that the training helped him to listen to everything the patient is telling him and to try to get on their level to understand what’s happening to them.
“Being there with the manikin and understanding what to do and seeing everything happen is a lot different from just trying to go over it in class or with a friend,” Becker, adding that the setting helped with the realism as well. “It is kind of different seeing the patient in a kitchen instead of on the classroom floor.”
The EMT simulation labs took four months to build, starting in September 2019 and completed at the end of January 2020. The cost of the project totaled just over $354,000. About 4,800 students are projected to run through the simulation labs each year.
Students will no longer rely on treating partial manikins in a bare classroom with little patient communication. They can now respond to a number of different real-world environments or situations where they are required to evaluate their setting, examine realistic patients, make treatment decisions and prepare their patients for transport to the next level of care.
EMT instructor Sgt. Latrelle Brigham experienced a lab for the first time while overseeing Blanchard, Becker and their team’s training scenario.
“It’s different to be on this side of the spectrum as opposed to actually going through the lanes because I was in their position at one time,” she commented.
“The sim labs have really come a long way from when I went through,” Brigham said. “The technology has really improved as far as the manikins can breathe, they can talk and their eyes move. I like the set up for the labs. We didn’t have any of that. The students now get a better feel for actual patients.”
Blanchard summed up the experience by explaining that there are certain things he and his fellow classmates are not going to realize in a classroom, such as how a patient might respond to questions.
“We’re doing this as professionals,” Blanchard said, “so getting more training under us and understanding more about patient interaction is going to make all the difference.”