Department of Military & Emergency Medicine, F. Edward Hébert School of Medicine, Uniformed Services University, Bethesda, MD 20814, USA.
F. Edward Hébert School of Medicine, Uniformed Services University, Bethesda, MD 20814, USA.
Mil Med. 2024 Jan 23;189(1-2):e298-e305. doi: 10.1093/milmed/usad317.
The battle along Antietam Creek in September 1862 was pivotal in shaping future combat medical readiness practices. With the full confidence of his commander, Major (Dr) Jonathan Letterman implemented an innovative ambulance corps system, which contributed immensely to modern-day battlefield medicine. Each year, the Uniformed Services University (USU) holds the Antietam Staff Walk, during which military medical students are engaged by faculty at various "stops" along the 6-mile walk. The four learning objectives for the Antietam Staff Walk are to (1) introduce the role of the "staff ride," (2) orient learners to reading terrain, (3) reinforce the six principles of health service support, and (4) recall the heritage of the military medical officer. The Department of Military and Emergency Medicine at USU commissioned a program evaluation to determine if these course objectives were being met, evaluate the effectiveness of the Antietam Staff Walk as a teaching tool, and make recommendations for improving its educational impact.
We engaged in qualitative program evaluation to evaluate the Antietam Staff Walk course objectives. Our research team analyzed 156 reflection papers written by second-year military medical students attending Antietam in August 2021. We coded each of the papers, noting important words and phrases that were salient to the students' learning experiences at Antietam. Our research team then compiled each of these codes into a master list and then determined how to divide this list into major categories. We collectively defined each of these categories, which served as the resulting themes of this program evaluation.
Three themes emerged: (1) creation of an ambulance corps allows for proximal battlefield medicine, (2) a lack of buddy aid inspires Tactical Casualty Combat Care, and (3) disease/nonbattle injury necessitates preventative medicine. The students foremost gained an appreciation for the impact of the ambulance corps and recognized that the ambulance corps not only impacted medical care, but also the mission as a whole. However, may not have completely understood the long, slow evolution of battlefield care and may have overestimated the knowledge of physicians practicing mid-19th century medicine. We provided recommendations for addressing these learning opportunities during future Antietam Staff Walks at USU.
Our review of the Antietam Staff Ride resulted in several curricular recommendations for enhancing its learning impact. Our program evaluation serves as a model for line units and other military organizations to optimize the impact of the historical staff ride as a teaching tool.
1862 年 9 月在安蒂特姆溪畔的战斗对战后医疗准备实践产生了深远影响。在指挥官的充分信任下,乔纳森·莱特曼少校(医学博士)实施了一项创新的救护车队系统,这对现代战场医学做出了巨大贡献。每年,美国武装部队大学(USU)都会举办安蒂特姆参谋步行活动,在此期间,军事医学专业的学生在教员的带领下在 6 英里步行的各个“站点”进行学习。安蒂特姆参谋步行活动的四个学习目标是:(1)介绍“参谋骑行”的作用,(2)使学习者熟悉地形,(3)强化卫生勤务支援的六项原则,(4)回忆起军医的传统。USU 的军事与急诊医学系委托进行了一项方案评估,以确定这些课程目标是否得到了实现,评估安蒂特姆参谋步行作为教学工具的有效性,并就如何提高其教育影响力提出建议。
我们采用定性方案评估来评估安蒂特姆参谋步行课程目标。我们的研究团队分析了 2021 年 8 月参加安蒂特姆参谋步行的二年级军事医学专业学生的 156 篇反思论文。我们对每篇论文进行了编码,记录了与学生在安蒂特姆的学习经历相关的重要单词和短语。我们的研究团队随后将这些代码汇编成一个主列表,然后确定如何将列表分成主要类别。我们共同定义了这些类别,它们构成了本次方案评估的主题。
出现了三个主题:(1)创建救护车队可以实现靠近战场的医疗,(2)缺乏战友援助激发了战术伤员救治,(3)疾病/非战斗伤需要预防医学。学生们首先认识到救护车队的影响,并认识到救护车队不仅影响医疗护理,而且还影响整个任务。然而,他们可能没有完全理解战场护理的漫长、缓慢演变过程,可能高估了 19 世纪中期行医医生的知识水平。我们为未来在 USU 举办的安蒂特姆参谋步行活动提出了一些建议,以解决这些学习机会。
我们对安蒂特姆参谋骑行的审查为增强其学习效果提出了一些课程建议。我们的方案评估为基层部队和其他军事组织提供了一个模型,以优化历史参谋骑行作为教学工具的影响。