Tag Archives: human-simulation training

Modernize U.S. military medical training to save lives and money

By Doris Browne, M.D., M.P.H.

Nearly 100 Republicans and Democrats have come together in support of an important bill โ€” Rep. Hank Johnson’s (D-Ga.) Battlefield Excellence through Superior Training (BEST) Practices Act (H.R. 1243).

If enacted, this bill would help doctors, medics and others save the lives of injured military service members by replacing ineffective and expensive trauma-training drills on animals with superior and less costly human simulation models.

I am a service-disabled veteran who spent nearly 28 years as a physician in the U.S. Army Medical Corps, and I currently serve as president-elect of the National Medical Association. I support this effort to modernize military medical training.

Many military medical personnel currently receive Cold War-era training that involves inflicting traumatic injuries on pigs and goats to learn how to repair injuries in humans. Some animals have very different anatomies from humans, which can inhibit successful translation of medical skills across species.

For instance, goats have 13 sets of ribs as opposed to 12 sets in human beings. Compared with humans, goats and pigs have smaller torsos, thicker skin and major differences in internal organs. Goats have a four-chamber stomach compared to the human one-chamber stomach, making goats poor models for teaching human abdominal procedures. Placing an epidural needle in pigs is different from doing this procedure on humans, as the respective spinal cords for pigs and humans end in different vertebral sections, and incorrect placement in humans could cause severe nerve damage.

Goats’ veins and arteries sit on top of the muscle and are easy to visualize, grab and clamp to stop a hemorrhaging wound. Human veins and arteries run through the muscle, and when damaged, they contract, making them difficult to grab and clamp to stop a hemorrhage.

Also, the pressure required to properly apply a tourniquet on a human’s limb is significantly different from that needed to apply one to a small goat’s limb. Failing to learn how to properly stop hemorrhaging wounds can have potential life-or-death consequences.

A recent study found that nearly a quarter of combat deaths from 2001 through 2011 were potentially survivable, and in 90 percent of these cases, avoidable deaths were due to massive blood loss.

Military medics shouldn’t be burdened with translating skills learned on an anatomically foreign, sedated goat or pig to a bleeding and screaming comrade on a chaotic battlefield.

A better training method would use anatomically correct, advanced human simulators that can breathe, bleed and even die just like real people.

The BEST Practices Act would help the military make the transition to using superior human simulation technology in place of animals for trauma training.

A recent Army study found that the agency could even save millions of taxpayer dollars with this transition.

Last month, the U.S. Coast Guard announced that it had suspended all animal use for trauma training. This policy shift will allow medical personnel to master emergency skills on realistic human anatomy, improve providers’ skill confidence and save the agency money.

The Department of Defense should follow suit by giving its medical personnel the human-simulation training tools they need to better save lives and permanently banning inferior, animal-based trauma-training methods.

Doris Browne, M.D., M.P.H., is a retired colonel who served nearly 28 years as a physician in the U.S. Army Medical Corps and is the president-elect of the National Medical Association, the largest and oldest national organization representing the interests of more than 30,000 African-American physicians and the patients they serve.