Cole Rebekah, Dong Ting, Rudinsky Sherri L, Tilley Laura, Reamy Brian V, Durning Steven J
Department of Military and Emergency Medicine, Uniformed Services University, Bethesda, MD 20814, USA.
Department of Medicine, Uniformed Services University, Bethesda, MD 20814, USA.
Mil Med. 2024 May 18;189(5-6):e1190-e1195. doi: 10.1093/milmed/usad430.
Military physicians must be prepared to lead health care teams across complex landscapes of war during future small- and large-scale combat operations. This preparation optimally begins in medical school so that early career physicians are fully ready for their first deployment. Past qualitative research has suggested that military physicians who attended civilian medical school are not as well prepared for the operational environment as physicians who attended the Uniformed Services University (USU), our nation's military medical school. However, there is a lack of larger-scale quantitative research comparing the readiness differences between the two medical school pathways. The purpose of this study, therefore, was to quantify any differences in first deployment preparation between students attending USU and civilian medical schools through the Health Professions Scholarship Program (HPSP).
We compared USU and HPSP graduates' first deployment experiences by distributing a 14-item Likert survey to active duty military physicians in the U.S. Army, U.S. Navy, and U.S. Air Force who graduated within the past 10 years from medical school (USU or civilian).
The USU graduates rated themselves significantly higher than the HPSP graduates on their readiness for deployment (3.83 vs. 3.24; P < .001); ability to navigate the operational environment (3.59 vs. 2.99; P < .001); confidence in communicating with their commanding officer (3.59 vs. 2.99; P = .002); navigating the combined role as physician and officer (3.33 vs. 2.84; P = .004); leading a health care team (3.94 vs. 3.43; P = .001); preparation by a medical school (3.78 vs. 2.52; P < .001); and overall readiness compared to peers (4.20 vs. 3.49; P < .001). There was no significant difference between the two pathways regarding their stress level at the beginning of deployment (2.74 vs. 2.68; P = .683); clinical preparation (3.94 vs. 3.76; P = .202); and success of first deployment (3.87 vs. 3.91; P = .792). The largest effect size of the difference between the two pathways was noted on the question "How well did medical school prepare you for your first deployment" (Cohen's d = 1.02).
While both groups believed that they were prepared for their first deployment, USU graduates consistently reported being more prepared by medical school for their first deployment than HPSP graduates. To close this readiness gap, supplemental military unique curricula may help to optimize HPSP students' readiness.
军事医生必须做好准备，在未来的小规模和大规模作战行动中，带领医疗团队穿越复杂的战争环境。这种准备最好从医学院开始，以便早期职业医生为首次部署做好充分准备。过去的定性研究表明，就读于民用医学院的军事医生对作战环境的准备不如就读于美国军事医学院——美国军医大学（USU）的医生充分。然而，缺乏大规模的定量研究来比较这两种医学院路径之间的准备差异。因此，本研究的目的是通过健康职业奖学金计划（HPSP），量化就读于USU的学生和民用医学院的学生在首次部署准备方面的任何差异。
我们通过向美国陆军、海军和空军中在过去10年内从医学院（USU或民用医学院）毕业的现役军事医生发放一份包含14个条目的李克特量表调查问卷，比较了USU和HPSP毕业生的首次部署经历。
USU毕业生在部署准备方面给自己的评分显著高于HPSP毕业生（3.83对3.24；P <.001）；在应对作战环境方面的能力（3.59对2.99；P <.001）；与指挥官沟通的信心（3.59对2.99；P =.002）；在履行医生和军官双重角色方面（3.33对2.84；P =.004）；领导医疗团队方面（3.94对3.43；P =.001）；医学院的准备情况（3.78对2.52；P <.001）；以及与同龄人相比的整体准备情况（4.20对3.49；P <.001）。在部署开始时的压力水平（2.74对2.68；P =.683）；临床准备（3.94对3.76；P =.202）；以及首次部署的成功率（3.87对3.91；P =.792）方面，两种路径之间没有显著差异。在“医学院对你首次部署的准备情况如何”这个问题上，两种路径之间差异的最大效应量被注意到（科恩d值 = 1.02）。
虽然两组都认为他们为首次部署做好了准备，但USU毕业生一直报告说，与HPSP毕业生相比，医学院让他们为首次部署做了更充分的准备。为了缩小这种准备差距，补充军事特色课程可能有助于优化HPSP学生的准备情况。
