Military Medical Training for Role 1 and Role 2 Combat Casualty Care Skills: A Narrative Review.

Abstract

Introduction: Military medics are often tasked to train other medics. While there is ample content of what to train, there exists a lack of trainer education or emphasis on how to train others effectively. Current military medical training is highly variable, often relying on anecdotal methods, with limited evaluation of training effectiveness. Although the importance of readiness training is well recognized, little attention has been devoted to identifying evidence-based approaches for training military medics. This narrative review sought to synthesize available evidence on training methods for military medics on skills performed in Role 1 or Role 2 settings.

Materials and methods: A narrative review using systematic search and screening methods was conducted. A research librarian searched multiple databases using the MeSH terms "clinical education" and "military." The articles were reviewed by the 6-person team using the Appraisal Tool Selection Algorithm and appraised for quality using the Pre-Appraised Evidence Appraisal Tool, © 2025 Johns Hopkins Health System, with permission.

Results: From 1,222 screened articles, 44 met inclusion and quality criteria for final synthesis. Two overarching themes emerged: training methods and training evaluation. Training methods varied by audience, design, and modality. Many studies developed training methods centered around the audience, whether individual or team-focused. Training design and content was variably informed by the utilization of clinical practice guidelines, literature reviews, needs assessments, and expert opinion. Most studies employed multimodal approaches combining didactic instruction with hands-on or simulation-based practice. Training evaluation included both subjective and objective measures, including self-efficacy, knowledge testing, time to task completion, graded simulations, and clinical practice volume.

Conclusions: This review highlights significant variability in how military medical readiness training is designed, delivered, and evaluated. Evidence suggests that effective training should be designed for the target audience, grounded in adult learning theories, multimodal, and evaluated using a combination of subjective and objective measures. Limitations to the articles utilized for this review include heterogeneous study designs, reliance on short-term outcomes, and weak generalizability. Addressing gaps in educator preparation, evaluation rigor, and policy for prioritization of training may improve the effectiveness of military medical readiness training. Future research should focus on validating objective evaluation tools, assessing skill retention, and optimizing team-based training to enhance operational readiness and force capability.