The colloquial saying of ‘we train how we fight’ is widely known across the ADF, and perhaps even more so throughout Army. The concept of using the real equipment, stores and processes in order to inform our training is not a new one, but it can be poorly executed.
A focus on medical education and training within Army from point of injury through to surgical simulation within the Role Two Echo and simulated evacuation on fixed and rotary wing assets is one example of how Army regularly trains. But why? And why must commanders fight for this type of training to be the future of Army medical training? The simple answer is that we do not rise to the occasion, we fall to our standard of training.
But it’s more than this. Half the battle of really caring for patients is about having the supplies and equipment to do so. Logistics and supply simulation MUST be ingrained into high fidelity training because if you don’t use it, you lose it. Our logistics and resupply is hardly ever truly put to the test, because why would you wait between 24 hours to 28 days for the things you need when you can get PTE Bloggs to put it on the next milk run? When we don’t allow these aspects of our supply chain to be tested, it’s impossible for them to fall to their standard of training, let alone rise to the occasion.
Why do we need high fidelity training and resupply simulation?
When a clinical team is out field, they are NO DUFF – i.e. they are there providing health affect to a real capability to ensure our troops are safe. As a result, training is not the focus for these teams. Further, the teams are often ad hoc, and filled with relatively junior clinicians. Whilst these clinicians are skilled in their own right, when teams haven’t worked together extensively before, it impairs clinical outcomes. Similarly, when teams haven’t trained with the real equipment and stores before, and haven’t had a chance to test how long things actually take, it impairs clinical outcomes.
Health commanders must give health clinicians time to train as a team and time to learn to refine their craft. They must also understand that the only way to get better, faster, stronger teams is to let them train with the right stores, the right equipment, and under real timelines. Because if we do not rise to the occasion; we fall to our standard of training.
Things take time, sim-isms aren’t real
Putting in a cannula takes time. Getting blood drawn takes time. Giving patients drugs and letting them take effect, takes time. Getting restocked takes time. When we only ever play our simulations according to ‘sim-ism’ without taking the actual time to do the physical actions of the task at hand, not only do we let our team down, but we are letting our capability down; as without real-time training, we can never truly test our capability.
This point stands not only in the medical world, but in the complex world of logistics as well. In order to truly have assurance of our logistics capabilities we must truly exercise them. If that means saying ‘no’ to the doctor, nurse or medic asking for the fifth bag of blood when we only carry four on the load list, then that is what is required to achieve the right training outcome. The austere environment requires both clinicians and logisticians alike to be adaptable and forward thinking; to have strategic perspective and apply pragmatic judgment to all tasks. This is what sets us apart from our civilian counterparts. When we don’t allow these aspects of our training to be tested, it’s impossible for them to fall to their standard of training, let alone rise to the occasion.
Commanders, clinicians and logisticians alike must be encouraged to rise to the challenge of truly testing our training and processes. How else will we ever know if we are truly good enough?