Scenarios Prep Reservists for Medical Records Task in Iraq

Bill Snethen and Ray Steen

Triaging mass casualties, tracking lab results, and reestablishing network connectivity are routine tasks in deployed treatment facilities. Each activity requires immense coordination. Active-duty medical units train daily, fine-tuning their efforts as a team. U.S. Army Reservists prepare in small groups one weekend every month leading up to their deployment date.

Helping to prepare Reservists for deployment to theater is the 191st Training Support Brigade (TSB), which readies 37 reserve medical units every year for the hardships and learning curves of theater. Field training exercises offer essential hands-on experience with the same equipment Reservists will use in the combat zone.

Unlike active-duty personnel, Reservists typically have little time to master the computer system Medical Communications for Combat Casualty Care (MC4), which they use on the battlefield to record, track, and share medical information. The flow of medical information supports operations on the ground, allows for greater situational awareness, and helps service members receive complete electronic medical histories.

In November, members of the 256th Combat Support Hospital (CSH), a Reserve unit, trained together for the first time at Fort Lewis, WA. Using MC4 systems, 200 Reservists readied for their split-based mission during a four-day field exercise, which helped the 256th CSH prepare for and avoid pitfalls downrange. Planned simulations showcased the need for more out-of-classroom training.

RECREATING THE BATTLEFIELD
“We replicate everything a medical unit will see in theater,” said LTC Paris Um, Deputy Exercise Director for the 191st TSB. “This is a good environment for unit commanders to see how the personnel respond to real-world situations. We set up units for success when they go downrange.”

The exercise, like the battlefield, operated 24-7. Ambulances delivered mass casualties with severe burns and shrapnel wounds. Actors portrayed Iraqi citizens seeking medical attention. The Reservists captured all patient data in MC4 systems, which remained operational during an unscheduled communications outage.

“We’re dealing with real-world conditions and problems,” said SGT Timothy Klaus, supporting the 256th CSH Signal Office. “We’ll be doing the same level of support when we deploy. If we arrived in theater without this experience, the hospital could be dead in the water.”

According to the Learning Pyramid developed by National Training Laboratories, people retain new information more effectively through active learning. The model illustrates that hands-on experience results in 75 percent training retention versus 30 percent typically achieved by classroom demonstration. The MC4 program refocused its training curriculum in 2010, placing greater emphasis on field exercises for deploying units. In 2010, MC4 supported 22 exercises worldwide.

Many members of the 191st TSB augmented MC4-led instruction, drawing upon their individual experiences with MC4 in theater.

“I deployed as a medic with the 41st Brigade Combat Team in 2009,” said SGT Richard Ramirez, 191st TSB. “When I talk with users, I stress the importance of electronically charting patient data right away. The digital notes benefit the patients, the medical teams, and the higher command.”

Because of their experience with the MC4 system, the 191st TSB could critique every aspect of the treatment facility’s implementation of MC4. They stressed the importance of accurately tracking patients throughout the facility, prioritizing the patient flow, and digitally monitoring and restocking supply shelves.

“The on-site training has been golden,” said LTC Diane Adloff, who will command one of the treatment facilities for the 256th CSH in Iraq. “It gives us time to practice for the realities of the battlefield. Everyone needs to understand our requirements the moment we hit the ground.”


  • BILL SNETHEN provides MC4 Program public relations support. He holds a B.A. in communications from William Paterson University. Snethen has more than 15 years of public relations experience.
  • RAY STEEN is the MC4 Public Affairs Officer. He holds a B.S. in public relations and corporate media communications from James Madison University. Steen has more than 14 years of integrated marketing communications experience.