Enhancing Interoperabillity Among Enlisted Medical Personnel: A Case Study of Military Surgical Technologists (Rand Corporation Monograph)

To reduce costs and increase interoperability of the military services, a joint medical education and training campus is being established at Fort Sam Houston, Texas with a view to consolidating training across the services. A methodology is outlined for defining and implementing a common standard of practice for a given specialty and its use illustrated through an application to the medical surgical technologist specialty. The U.S. Congress directed the Secretary of Defense to conduct an assessment of recruiting efforts, admissions policies, graduation rates, and career success rates with respect to the diversity of entrants and graduates of the United States Military Academy, the United States Air Force Academy, and the United States Naval Academy. Data provided by the service academies on the demographics of recent entering classes and their outcomes (such as first-year completion rates, graduation rates, completion of initial service obligation [ISO] following graduation, and propensity to stay in the military beyond ISO completion) allowed a descriptive analysis of trends across years and a comparison with similar data on very selective civilian four-year institutions. Although the percentages of women and nonwhite entrants have increased, these groups tended to have lower graduation and ISO completion rates than their counterparts. However, in recent entry cohorts, these groups showed improved graduation rates, and the rates were similar to or higher than those in civilian institutions. The U.S. Department of Defense can support service efforts to increase diversity in the academies by developing a standardized definition of diversity, reviewing goals and metrics to measure progress in this area, and improving career retention of a diverse group of officers One way to enhance the interoperability of medical service personnel is by training service specialists to a common standard. A methodology is outlined for defining a common standard of practice (SOP) that can be applied to any enlisted medical specialty with the goal of consolidating training for enlisted military personnel across the services. The methodology involves three analytic tasks: Define a common SOP for the specialty, validate it through reviews by military and civilian subject matter experts, and identify a set of training options that will result in the required number of specialists trained to a given level of proficiency. The methodology is illustrated by applying it to the military surgical technologist specialty. The authors examine the commonality of work across services rather than commonality of training as currently provided to define a common scope of practice. They identify and evaluate different training methods and different ways of obtaining qualified medical personnel. However, the authors note that achieving common training is a necessary but not sufficient condition for achieving interoperability and that interoperability may be more easily achieved in future years as other transformational initiatives are implemented.