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METC creates innovative training to graduate RT students

Two medical personnel with a simulated baby in a medical setting Navy Petty Officer 2nd Class Jawaun White, a phase 2 student and Navy Petty Officer 1st Class Gina Martinez, a phase 2 Instructor in the Medical Education and Training Campus (METC) Respiratory Therapist program prepare to fit a neonatal oxygen mask on an simulated infant in the Neonatal Intensive Care Unit. White and his classmates were completing the clinical portion of their training when the national COVID-19 response compelled medical facilities to postpone non-invasive and non-urgent procedures which impacted their ability to finish their clinical rotations. The class returned to their phase 1 training site at METC to complete the remainder of their clinical rotations in a simulated environment and graduated on May 7.

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FORT SAM HOUSTON, Texas – Respiratory therapists (RT) the world over have been called to the frontlines in the battle against the novel coronavirus, known as SARS-CoV-2. Preparing to join the fight are 27 military respiratory therapist students who graduated training in early May.

The 32-week Army/Navy Consolidated Respiratory Therapist (RT) program is divided into two phases, and teaches students the skills necessary to function as competent respiratory therapists in critical care areas.

The first 16-week phase is the didactic portion conducted in the classroom and simulation laboratories at the Medical Education and Training Campus (METC) on Joint Base San Antonio-Fort Sam Houston, Texas. Training involves classroom instruction and hands-on practice in the program’s mock intensive care units (ICU) that utilize realistic, hi-fidelity manikins that simulate ICU patients. The manikins can be programmed to present a variety of vital signs and symptoms, as well as talk, cough, and make other sounds.

Phase 2 included clinical training at the Brook Army Medical Center where students apply their classroom and lab training in a variety of supervised clinical settings that involve hands-on patient contact. Students rotate between different departments to gain more in-depth experience and knowledge of respiratory issues, to include hospital wards, intensive care units, pulmonary function laboratory, pulmonary rehabilitation, and sleep laboratory.

It was toward the end of phase 2 clinical training for RT class 19-015 that medical facilities began to postpone non-invasive and non-urgent procedures in support of the national COVID-19 response.

Due to the COVID-19 impacts on numerous military treatment facilities, the Defense Health Agency enacted a policy to reduce medical and dental care across the Military Health System. This new policy had a direct impact on the students’ ability to complete their clinical rotations to graduate.  

Like many educators who were compelled to think outside the box, the RT clinical instructors sought to create a workaround to this unique situation.

“The instructors wanted to ensure that training didn't cease during the COVID-19 pandemic,” stated Army Staff Sgt. Joshua Dixon, non-commissioned officer in charge of RT phase 2 clinical training.

To complete their training, the students returned from BAMC to the METC to complete the clinical portion in the simulated ICU labs.

“With the reduced capabilities and to ensure the safety of our students,” added Dixon, “We chose to utilize the phase 1 mock ICUs at METC in order to test the students’ abilities as newly trained RTs.”

Dixon explained that to comply with social distancing guidelines, the class was split into smaller groups and each student assigned a specific time to conduct the simulation training. Eight labs, or stations, were set up, each with a different scenario and staffed by the phase 2 clinical training instructor who normally teaches that scenario.

During the rotation students were expected to trouble shoot a ventilator, assess a trauma patient, participate in a code blue emergency, attend a mock pre-term neonatal delivery and resuscitate the newborn, assist with a bedside bronchoscopy, intubation and extubation of a patient, and perform a non-invasive ventilation. A COVID-19 scenario was also incorporated.

“It was well put together by the instructors," expressed Army Sgt. Jasmin Fabre, one of the RT students in the class, who thought the scenario simulations were worthwhile. "This training helped me with the application of skills that RT's possess in lieu of seeing live patients.”

It is unclear whether phase 2 training will return to normal for the next class, but Dixon is hopeful that his team will be prepared.

 “If restrictions are not lifted we will discuss how we will go about training during this pandemic,” he stated. “We’ll be ready.”

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