Bushmaster, Gunpowder Exercises Held After Overcoming COVID Challenges

By Ian Neligh

Undeterred by the many challenges of COVID-19, the Uniformed Services University of the Health Sciences successfully carried out its two largest field exercises for students in March and April. 

After being postponed in October 2020, the university held its Medical Field Practicums Gunpowder and Bushmaster with the help of months of planning and streamlining, while maintaining its goal of academic excellence. 

The practicum organizers said it is important students had the chance to participate in the training events, picking up the skills that may be essential to their future medical careers. 

Bushmaster

This year’s shortened Bushmaster practicum for the class of 2021 began on April 28 and ran through May 6 at the National Guard Training Center in Fort Indiantown Gap, Pennsylvania. 

Air Force Lt. Colonel (Dr.) Leslie Vojta, Bushmaster’s academic director, said having a scaled down event didn’t mean they intended to water down the course’s mission.

“We knew we needed to accomplish the same objectives because we have promised the military health system that a USU graduate who has finished Bushmaster has certain skills and experience,” Vojta said.

Fourth-year medical school students and graduate nursing school students at the Uniformed Services University of the Health Sciences engaged in a variety
of field exercises as part of the Bushmaster medical practicum April 28 through May 6 at Fort Indiantown Gap, National Guard Training Center in
Pennsylvania. (Photo by Tom Balfour)

The goal of the university’s Bushmaster practicum is to introduce this year’s  185 students to the types of chaotic scenarios they might face in medical emergencies — especially when they are in austere environments and may not have access to the best infrastructure. 

The practicum assesses the students’ skills such as casualty care under realistic conditions, while simulating a deployment. Both fourth-year students from the School of Medicine and students from the Graduate School of Nursing learn about leadership and teamwork as they provide care to patients during mass casualty exercises, simulated mortar attacks and gunfire attacks.

“Our fourth-year medical students have been preparing for the entire four years — this is the culmination of their entire military unique curriculum,” Vojta said. 

The university’s first-year medical students stepped in as role-players, something Vojta said they worked hard to prepare for.

Organizers decided one way to help mitigate the risk of COVID infection was to have the student groups broken down into smaller squads instead of larger platoons. 

“And the same group worked together and did not interact with other student groups for the entire time that they were in the field, so that we could try to limit disease transmission and still get our mission accomplished,” Vojta said. “Normally we’d have a lot more faculty, we’d have a lot more role players, simulators, and we would set up a host nation village the students could visit.”

This year those extras are on hold as the organizers worked to limit the amount of people involved in the field training. Some situations faced by the students ended up being virtual where they could meet, speak with, and treat residents from a fictional village. 

“It is a culmination of what we’re preparing them for, but it’s also really a time that they solidify their confidence in their ability to step into an unknown, chaotic situation and lead,” Vojta said.

The class of 2022 is expected to experience Bushmaster at its regular size later this October.

Gunpowder

The university cancelled Gunpowder last year, just three days before its start date. With all the uncertainty of 2020, this year the medical school decided to hold a scaled-back version of the exercise on March 8-12.

The goal of Gunpowder is to help expose third-year medical students to a variety of challenges they may come across in the field. Students train on tactical field care, tactical combat casualty care, prolonged casualty care and forward resuscitative care. The university held the exercise this year at USU’s Val G. Hemming Simulation Center, in the Forest Glen section of Silver Spring, Md.

Third-year students at the Uniformed Services University of the 
Health Sciences took part in the annual Gunpowder medical field
practicum in March at USU's Val G. Hemming Simulation Center,
in the Forest Glen section of Silver Spring, Md. (Photo by Tom Balfour)

Academic director Army Major (Dr.) Laura Tilley said COVID forced the exercise this year to cut back on the number of instructors supporting the event to keep potential virus exposures to a minimum.

“Despite these challenges and limitations, I feel that my NCOIC, HM1 Jeffery Thompson, and I maxed out our left and right limits to create an excellent educational experience for our students,” Tilley said. 

Tilley added the crucial learning experience of Gunpowder would not have been possible without the hard work and dedication of its instructors, the simulation center faculty, and USU staff.

“We just decided this is a very important event for our students, and a portion of Gunpowder is the hands-on skills that they learn,” Tilley said. “If students want to give a medication or transfuse blood, they’re setting up the IV tubing or actually calculating how much medication — they need to learn what is typically done by nurses and medics. So the end goal was to figure out how to safely do that.”

Fewer faculty and students were necessary, as well as replacing the practicum's use of real vehicles in favor of simulators to train students how to work inside a moving vehicle. Tilley said they created dark, confined and loud spaces to give the students an idea of what a flight medic might experience.

“The students were super flexible, they went with the flow and understood that this is hard,” Tilley said. “Contingency planning is my life. As an officer, and as an emergency clinician, this is my lane. So it was very important to maximize the contingency planning for this and decide when they needed to be made to make Gunpowder happen for the students.”