Institute of Clinical Sciences, Department of Surgery, Sahlgrenska Academy, Gothenburg University, 405 30, Gothenburg, Sweden.
Department of Research and Development, Swedish Armed Forces Center for Defense Medicine, 426 76 Västra Frolunda, Gothenburg, Sweden.
Mil Med. 2021 Jan 30;186(3-4):e442-e450. doi: 10.1093/milmed/usaa364.
Historical changes have transformed Sweden from being an offensive to a defensive and collaborative nation with national and international engagement, allowing it to finally achieve the ground for the civilian-military collaboration and the concept of a total defense healthcare. At the same time, with the decreasing number of international and interstate conflicts, and the military's involvement in national emergencies and humanitarian disaster relief, both the need and the role of the military healthcare system within the civilian society have been challenged. The recent impact of the COVID-19 in the USA and the necessity of military involvement have led health practitioners to anticipate and re-evaluate conditions that might exceed the civilian capacity of their own countries and the need to have collaboration with the military healthcare. This study investigated both these challenges and views from practitioners regarding the benefits of such collaboration and the manner in which it would be initiated.
A primary study was conducted among responsive countries using a questionnaire created using the Nominal Group Technique. Relevant search subjects and keywords were extracted for a systematic review of the literature, according to the PRISMA model.
The 14 countries responding to the questionnaire had either a well-developed military healthcare system or units created in collaboration with the civilian healthcare. The results from the questionnaire and the literature review indicated a need for transfer of military medical knowledge and resources in emergencies to the civilian health components, which in return, facilitated training opportunities for the military staff to maintain their skills and competencies.
As the world witnesses a rapid change in the etiology of disasters and various crises, neither the military nor the civilian healthcare systems can address or manage the outcomes independently. There is an opportunity for both systems to develop future healthcare in collaboration. Rethinking education and training in war and conflict is indisputable. Collaborative educational initiatives in disaster medicine, public health and complex humanitarian emergencies, international humanitarian law, and the Geneva Convention, along with advanced training in competency-based skill sets, should be included in the undergraduate education of health professionals for the benefit of humanity.
历史的变迁使瑞典从一个进攻性国家转变为一个具有国家和国际参与的防御性和协作性国家，最终为军民合作和全民防御医疗保健理念奠定了基础。与此同时，随着国际和国家间冲突的减少，以及军队参与国家紧急情况和人道主义灾难救援，军队医疗体系在民间社会中的作用和需求都受到了挑战。最近美国 COVID-19 的影响以及军队的参与必要性，促使医疗从业者预测和重新评估可能超出本国民间能力的情况，并需要与军队医疗保健合作。本研究调查了从业者面临的这些挑战和观点，以及他们对这种合作的好处的看法，以及启动这种合作的方式。
采用名义群体技术制作问卷，对有反应的国家进行了一项初步研究。根据 PRISMA 模型，对相关的搜索主题和关键词进行了系统的文献回顾。
对问卷做出回应的 14 个国家要么拥有发达的军队医疗保健系统，要么与民用医疗保健合作建立了相关单位。问卷和文献回顾的结果表明，需要将军队医疗知识和资源在紧急情况下转移到民用卫生部门，这反过来又为军队人员提供了维持技能和能力的培训机会。
随着世界目睹灾害和各种危机病因的迅速变化，军队和民用医疗保健系统都无法独立应对或管理这些结果。这两个系统都有机会合作发展未来的医疗保健。重新思考战争和冲突中的教育和培训是无可争议的。在灾难医学、公共卫生和复杂人道主义紧急情况、国际人道法和日内瓦公约方面开展协作性教育举措，以及在基于能力的技能培训方面开展高级培训，应纳入卫生专业人员的本科教育，造福人类。
