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Thursday, December 12, 2019

Computer Based Training and NHCS. A Chief’s View, How we did it, and how it was fixed.

June 17, 2009 by  
Filed under Corpsman.com News, Navy News

A bit of history.

As many of you know, I was a instructor at Naval Hospital Corps School from 2004-2007 upon my retirement.  During this time, we were on the leading edge of initiating a Computer Based Training Curriculum for all of Naval Hospital Corps School.  I will go into the positives and negatives that “I” found while working with this system.  You might be surprised on what I thought through out the process.

I will quote a portion of the IG Inspection report talking about NHCS below:

1. Hospital Corpsman. “A” School.

a. In 1999, the medical community was one of hte first to embrace computer based training (CBT), with the implementation of a CBT Emergency Medical Technician (EMT) course. The Hospital Corpsman (HM) “A” School was moved to a CBT model in early 2006. Under the CBT model, there was an increase in failures, a large student backlog in the self-paced courses and increased disciplinary problems. Surveys sent to Military Treatment Facilities (MTF) on HM performance indicated that Corpsmen were unable to perform the basic skills such as draw blood, administer immunizations or record a blood pressure.

b. In 2007, the school hous reorganized and introduced the Hospital Corpsman
Interactive Course ( HMIC), which features a blended training environment. This training curriculum, developed by on-site instructors was most impressive. It combines initial CBT and interactive course-ware with instructor led training( ILT), psycho-motor skills demonstrations, and hands-on laboratory motor exercises with simulation mannequins and clinical practicum enhancing the required corpsman knowledge, skills and abilities( KSAs). Additional self-study via CBT is available to all students. Under HMIC, there was an increase in test scores and a reduction in failure rates and disciplinary issues. Morale improved and cooperative team work efforts became commonplace.

c. By design, the HMIC purposefully foster an “esprit de corps” among students
through a cooperative learning strategy. Students view the instructors as role models, and look to emulate them once in the Fleet. We noted a great deal of pride and professionalism in the HM rate and its history. The HMIC provides great insight on how the latest technology can be combined with ILT and hands-on application to yield an effective training program.

I have the entire IG report here for to read, it tells all the positives as well as the negatives of having Computers Train our Sailors. What I want to talk about though are the failures that “I” felt the command made when we switched to all computer based training, moving the instructors out of the classroom.

The Number “1” problem with how NHCS moved to the CBT 100% Training?

The decision was made at the top of the Chain of Command (COC). No input was gathered from those who had served as Corpsmen in Clinics, Hospitals, or more importantly, in the field. I can tell you having been a BN Medical Chief with a Marine Artillery unit, While we do train 24/7, our motto is train as we fight and fight as we train, there are certain things I expect my Corpsmen to be able to know and understand upon reporting to our unit.

Basics, the very basics, as the report accurately reported, we were sending folks out to the fleet who could pass a computer test, but could not put hands on a patient to administer a shot, do basic TPR’s or even understand what the heck a TPR was!

Why did this go on?

Lack of Communication.

Big Navy wanted us to cut our Days in Curriculum down, in other words BUMED, BUPERS, wanted us to cut down the number of days a student was in our school house to cut down on $$.

At the time NHCS offered a computer based training program for Reserves who had never been to Corps School (Don’t even get me started on that program, the old Advanced Pay Grade (APG) program). It was found that sending people to War in the 1st Gulf War who didn’t understand the Navy or the practices in the Naval Medical Department were a drag to the medical program when they reported for duty. Reservists were activated to work in a medical department role alongside their active duty counterparts, but were showing up not knowing how to wear a uniform, lack of training in Navy Practices as well as our sister services etc.

Senior Chief Cangelosi, (Just selected to HMCM) saw the problem, and started pushing BUMED to have NHCS offer a program to get APG reservists up to speed. I can tell you having been the Program Manager at NHCS for this program, It was a “PAIN IN MY ASS”. I can say this about it now though on hindsight, HMCM Cangelosi, NAILED IT.

She saw what others didn’t, it wasn’t necessarily the CBT Training, it was the hands on that actually provided what the Sailors needed.

While I was the Corps School Program Manager for the program, Master Chief Cangelosi, who was stationed up at BUMED in DC, would support our staff by sending me Veteran Reserve Doc’s who had been deployed or were senior enough but had been through NHCS themselves as students back in the day. These Reserve Instructors would go through a intensive “Instructor” program to assist the Active Duty Instructors on all the Lab tests that had to be done for the Reserve Students. The program was so good, that we would often times have Reserve Instructors come throughout the year to supplement our active duty staff beit for IA deployments or leave or what have you. I can say without a doubt, this part of the program worked seamlessly. There were bumps along the way, but it worked.

Reservists would do 74 courses online while living at home. After completion of the coursework they would come to NHCS for 2 weeks and be Classed Up just as their active duty counterparts were. They lived in the barracks and were subject to the same rules and regulations as all the Sailors at Corps School.

The Students were taught by both Active as well as Reserve Instructors in the school house. It was sometimes quite comical to see us trying to jam a full 14 week training program into 2 weeks, and by this I don’t mean the didactic portion, but the “Esprit De Corps” as was mentioned in the report. This is not something that can be taught, you have to Live it.

Right now you have Doc’s who are out there doing the job on deployments, or even have gone back to active duty, all the while most cannot even tell they were APG students at one time.

All of this can be attributed to “1” Persons dream. HMCM Cangelosi.

Now, how does this differ from the active duty program? I can list them below.

  • While I hate, and I mean HATE meetings, HMCM Cangelosi was a stickler about communication about this program.  While I thought some of the info was redundant, She was taking EVERYTHING in from everybody and making decisions up in BUMED with the data that we collected.  Never was a decision made without first hearing from those who were working with the students or the instructors.  This is not to say like I said before that we didn’t have our problems, boy did we, but we overcame them with communication.
  • There were times HMCM drove me absolutely bonkers.  But now looking back in hindsight, She nailed it, the whole program, to this I say “Congrats”
  • The way the Active Duty side went off the tracks?  “0” Communication, other then to be told we were “GOING TO DO IT”.  Never once did the Chain of Command go to the Chief’s who were leading the respective classes, what we thought about the changes etc.  Almost all the Enlisted staff at NHCS have been deployed in one fashion or another.  I still remember the day when we were all called into a meeting and told that this change was going down.  There was “0” discussion, it was to happen.
  • Corps School went from having leaders teaching the chain of command, teaching teamwork etc, to basically throwing a switch and then all the students were now being taught by computers.  There was no more class cohesiveness,  You could come to Corps School one day and graduate sometimes 21 days later, others of course took longer, it was a Self paced program.  Military bearing started to go out the window it became a race to see who could graduate the fastest.  Students were not looking out for their shipmates, more so the opposite.
  • You need to listen to your Chief Petty Officers, and Junior Officers who have been deployed.  If you have been on Staff Duty for the last 5-10 years, you have no clue as to what is expected nor required in the operational theater.  This is why you have Chief Petty Officers for crying out loud.  It also did not help that we had a “YES MAN” in the CMC office at the time either, (My Opinion) to stand up for the Mess when we were telling or trying to tell the leadership what would happen.  a “COVEY” Course does not the CMC make.

That being said, the good thing about the Military,

ROTATIONS!!!

Those who had made poor decisions moved along and new folks came in who did listen.   A new CMC transferred in from the Marine side of the house, who was a chief’s mess Master Chief.  He listened passed up the chain our views etc.  He had the gumption to stand up for what was right etc.  He also had a birds eye view of what we were sending to the fleet and had heard the complaints from our customers out at Division, the Squadrons, Ships etc.  Not only had the prior leadership not listened to us the staff, they were not listening to the customers at FMTB, nor at the commands.

Ultimately it came down to $$, pressure was being put on our C.O. to cut the days of  students at school, but it came at a price to our LPO’s and Chief’s working in the units in the fleet who should have been getting ready for deployments etc, taking care of their Sailors, Marines, Soldiers etc, but now had to also take the time out to train the basics to new Corpsmen.

My Advice to leaders, GET ADVICE FROM THOSE WHO ARE CURRENTLY DOING THE JOB!!

Never shoot from the hip, Believe it or not OFFICERS, Chief’s have a better grasp on the day to day goings on in your command.  We listen to those who work for us and with us.

The soapbox is now open for comments. 🙂

But first my Comment.  This was discussed as it was happening on our Forums which you can read @ http://www.corpsman.com/forum/ I and our staff went over this again and again during this time frame.  The forums are free and I hope you look into it!

You can read the entire CBT IG report here: CBT_IG_REPORT

Comments

4 Responses to “Computer Based Training and NHCS. A Chief’s View, How we did it, and how it was fixed.”
  1. 8404 says:

    While, Computer Based Training has it's place, I don't believe it's the panacea to classroom instructor based learning. Students need to be able to put what they have learned into practice, via hands-on practicals. Some things cannot be put into words, like what it feels like attempting to find a suitable vein for venipuncture.

    While not a Corpsman myself, my past medical history has put me on the receiving end of what you all do. Why is it that every time I go into the hospital, it's the civilian nurses who have difficulty finding a vein, but a former 68W or Navy Corpsman, find them the first time, every time and in record time.

    With regards to this article, this will not be the only time the military or civilian corporations sacrifice quality for the pursuit of cost savings! Cudos, to HMCM Cangelosi for successfully negotiating with the upper echelon of BUMED an alternative that meets everyone's needs.

  2. Ben P says:

    The idea of complete CBT for a bunch of young sailors was a little strange when I first heard it. For a couple of reasons, first we're talking about a lot of 18 to 21 yr olds without much formal education, who have just been to bootcamp. They would need to pretty driven to keep up with what had to be learning some pretty foreign material. I have done a lot of computer courses for college, but I was already an RN. I had all the hands on stuff that I needed. I even did some of Master's online, but any hands on and true new skills were done in the classroom or a lab. The research crap was just that, but diagnosing and treating patients was treated very differently.
    Secondly, there is no group cohesion in a completely computer based course. When I was in Corps school, the stronger students helped the weaker ones. We were a company and we were still learning about the Navy. Besides our instructors, we had a company co. and an asst., both HM1's going thru a “C” school themselves.

    So, I agree with a mixed approach. There is more to Corps School than passing a few tests on a computer.

    Ben

  3. hm1dana says:

    Chief,
    As you can imagine, I am right there with you, as I was back then teaching with you. I had wanted to be a Hospital Corps School Instructor from the day I graduated Corps School in 1995. I fought very long and hard to get those orders and was one of the few at the time that actually wanted to be there instead of being forced. I can honestly say with exception of the last 6-9 months of my tour, it was the best tour I ever had and I enjoyed it tremendously! Over my 4 years as an instructor, I went from fundamental area team teaching (go team 1), to pushing an entire class through the entire curriculum (my favorite by a long shot) to the computer based training (total waste of time in my opinion) and caught the tail end of the “improved” blended learning. When I first got to Corps School and we actually “taught” things were so much better. The moral of the students was the biggest thing. There were less disciplinary problems because you were seen as an instructor and a mentor. You had the opportunity to mold these young people into sailors. This was even more evident when we pushed a whole class through the curriculum. They had 3 staff to go to at all times. They knew what was expected and when. We had very low attrition rates and even less disciplinary problems. But then as the Navy wanted to save money, our program was affected. We went to the computer based training over what seemed to be overnight. After a couple months it was evident to all of the instructors, what a horrible plan this was. All of voiced our opinions, but it was never taken into consideration. At the point that I had transferred, I felt more like a babysitter than I did an instructor.
    I am glad to hear that someone finally listened to the fleet about the poor quality “HMs” we were producing, and made a change. The children of this generation do enough sitting in front of a computer. But sitting infront of a computer screen cannot teach you how to treat a human being. There has to be a personal approach.

  4. Callahan says:

    Interesting report. I'm a civilian, I just came across this while doing some research about online education. For learning academic subjects, CBT works pretty well. For math classes especially, going at your own pace makes sense (Carnegie Mellon's website has some free math and science courses that are pretty impressive). But if a sailor or marine needs a corpsman, book knowledge only takes you so far.

    Sorry if this a dumb, lubberly question but since there's typically a lag between a recruit signing a contract and actually shipping off to boot camp, why not use that wait time for the recruits to complete a CBT course at home? Some recruits won't have the time to get through it, to be sure, and they could still start from scratch at their A-school.
    .
    But the recruits who “test out” of the online exams could be taught as a separate cohort by instructors who can assume they have the theoretical knowledg and move to advanced skills or practical applications sooner at no additional cost to the Navy. I seem to recall that the Air Force conducts its reserve medical officer training that way. The docs have to go through a self-study course at home. Once that's complete, they ship off for their two week knife and fork school.

    Of course the AF docs get their medical knowledge from med school, the self-study program is just basic stuff– who to salute, military law, the history of the Air Force (who knew they won World War II single-handedly?), etc. :o)