Considerations to Optimize Structurally Responsive Work Environments for U.S. Military Specialty Physicians.

Introduction: Recruitment, training, and retention of wartime critical specialty physicians may be stymied by discrimination and abuse. It is unclear to what extent the US combat specialty physicians witness or experience discrimination and abuse, whether they or others intervene, and if they would subsequently discourage people from entering their field.

Materials And Methods: The present study surveyed US active duty anesthesiologists, emergency medicine physicians, and orthopedic surgeons (N = 243; 21% response rate).

Analyzing unmanned aerial vehicle (drone) attacks; a disaster medicine perspective.

Introduction: Unmanned aerial vehicles (UAVs), more commonly known as drones, have rapidly become more diverse in capabilities and utilization through technology advancements and affordability. While drones have had significant positive impact on healthcare and consumer delivery particularly in remote and austere environments, Violent Non-State Actors (VNSAs) have increasingly used drones as weapons in planning and executing terrorist attacks resulting in significant morbidity and mortality. We aim to analyze drone-related attacks globally against civilians and critical infrastructure for more effective hospital and prehospital care preparedness.

Racialized and beneficiary inequities in medication to treat opioid use disorder receipt within the US Military Health System.

Background: Medication for opioid use disorder (MOUD) can be critical to managing opioid use disorder (OUD). It is unknown the extent to which US Military Health System (MHS) patients diagnosed with OUD receive MOUD.

Methods: Healthcare records of MHS-enrolled active duty and retired service members (N = 13,334) with a new (index) OUD diagnosis were included between 2018 and 2021, without 90-day pre-index MOUD receipt were included.

A Comparison of Uniformed Services University and Health Professions Scholarship Program Graduates' First Deployment Readiness.

Introduction: 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.

Medical Students' Integration of Formative Feedback During Simulation: A Grounded Theory Study.

Introduction: Formative feedback is critical for trainees' growth and development. However, there is a gap in the professional literature regarding the ways in which formative feedback affects student performance during simulation. This grounded theory study addresses this gap by exploring the ways in which medical students received and integrated ongoing formative feedback throughout a multiday, high-fidelity military medical simulation, Operation Bushmaster.

The Impact of Operation Bushmaster on Medical Student Decision-making in a High-Stress, Operational Environment.

Introduction: Operation Bushmaster is a high-fidelity military medical field practicum for fourth-year medical students at the Uniformed Services University. During Operation Bushmaster, students treat live-actor and mannequin-based simulated patients in wartime scenarios throughout the five-day practicum. This study explored the impact of participating in Operation Bushmaster on students' decision-making in a high-stress, operational environment, a crucial aspect of their future role as military medical officers.

Prior Enlisted Medical Students at the Uniformed Services University: Outcomes During Four Years of Medical School.

Introduction: The Uniformed Services University (USU) implemented the Enlisted to Medical Degree Preparatory Program (EMDP2) with the goal of enhancing the diversity of the military physician corps. Programs like EMDP2 can assist students in making the social and intellectual transition from undergraduate studies to medical school and beyond. These types of programs are also opportunities to reduce health disparities and prepare students to work in multicultural settings.

The Impact of Special Operations Medics and Corpsmen on Military Medical Student Training: A Qualitative Study.

Operation Gunpowder is a high-fidelity military medical field practicum conducted by the Uniformed Services University of Health Sciences, Bethesda, MD. During this multi-day combat simulation, Special Operations Medics and Corpsmen teach military medical students how to treat patients in an austere, resource-limited environment. To investigate the effectiveness of this teaching model, our research team used a qualitative phenomenological design to explore medical students' experiences being taught by Special Operations Medics and Corpsmen during Operation Gunpowder.

Airway and Hypothermia Prevention: and Treatment via STEAM The System for Thermogenic Emergency Airway Management.

Military medicine has made significant advancements in decreasing mortality by addressing the lethal triad - metabolic acidosis, coagulopathy, and hypothermia. However, casualties are still succumbing to injury. Recent conflict zones have led to the development of remarkable life-saving innovations, including the management of compressible hemorrhage and whole blood transfusions.

Military Response to Medical Crises-Consensus Recommendations for Military-Civilian Transitions of Care.

Objective: The threat that New York faced in 2020, as the COVID-19 pandemic unfolded, prompted an unprecedented response. The US military deployed active-duty medical professionals and equipment to NYC in a first of its kind response to a "medical" domestic disaster. Transitions of care for patients surfaced as a key challenge.

Military Medical Provider Perspectives During the New York COVID-19 Response.

Introduction: The response to the coronavirus disease 2019 pandemic in New York City (NYC) included unprecedented support from the DoD-a response limited primarily to medical and public health response on domestic soil with intact infrastructure. This study seeks to identify the common perspectives, experiences, and challenges of DoD personnel participating in this historic response.

Materials And Methods: This is a phenomenological qualitative study of 16 military health care providers who deployed to NYC in March 2020.

Naloxone Prescribing Associated With Reduced Emergency Department Visits in the Military Health System.

Purpose: The aim was to determine the association between the receipt of naloxone and emergency department (ED) visits within 60 days after the receipt of an opioid.

Methods: A retrospective cohort of individuals 18 years of age or above, enrolled in TRICARE, and were dispensed an opioid at any time from January 1, 2019, through September 30, 2020 was identified within the United States Military Health System. Individuals receiving naloxone within 5 days of the opioid dispensing date were propensity score matched with individuals receiving opioids only.

Medical Students' Professional Identity Formation During Operation Bushmaster.

Introduction: The role of the military medical officer is complex, as it encapsulates officer, physician, and leader. Professional identity formation is therefore essential for military medical students and junior military physicians to successfully execute the responsibilities of the military medical officer in their future careers. Because little is known regarding best practices for professional identity formation training for military physicians, this study explored the ways in which medical students conceptualized the complex roles of the military medical officer during a medical field practicum.

Naloxone prescribing practices in the Military Health System before and after policy implementation.

Introduction: Despite public health campaigns, policies, and educational programs, naloxone prescription rates among people receiving opioids remains low. In June 2018, the U.S.

Potentially survivable fatal vascular access hemorrhage with tourniquet use: A post-mortem analysis.

Background: The US military has prioritized battlefield hemorrhage control. Researchers credit tourniquet use, and a novel trauma care training program, with saving 1000-2000 lives in Iraq and Afghanistan. The Stop the Bleed campaign translates these lessons learned to the public.

Emergency Department Utilization in the U.S. Military Health System.

Introduction: Emergency department (ED) utilization represents an expensive and growing means of accessing care for a variety of conditions. Prior studies have characterized ED utilization in the general population. We aim to identify the clinical conditions that drive ED utilization in a universally insured population and the impacts of care setting on ED use and admissions in the U.

Super-Utilization of the Emergency Department in a Universally Insured Population.

Introduction: Super-utilizers (patients with 4 or more emergency department [ED] visits a year) account for 10% to 26% of all ED visits and are responsible for a growing proportion of healthcare expenditures. Patients recognize the ED as a reliable provider of acute care, as well as a timely resource for diagnosis and treatment. The value of ED care is indisputable in critical and emergent conditions, but in the case of non-urgent conditions, ED utilization may represent an inefficiency in the healthcare system.