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Dr. Barnes
Stephen Barnes, MD, chief of acute care surgery at the University of Missouri, uses clinical simulation resources at MU's medical school and elsewhere to lead a national team in studying how to improve training for combat medics. Their research is funded with a $5.3 million federal grant.


MU Awarded Grant to Lead Study on Future of Combat Casualty Care


National team will discover ways to improve the next generation of military medical training with $5.3 million in new federal funding

On the battlefield, a medic serves as the front line of emergency care, treating the wounded and preparing them for evacuation from danger. The University of Missouri has received a $5.3 million grant to evaluate and refine how those critical responders will be trained in the future using simulation.

With the United States Department of Defense funding, MU has established the Combat Casualty Training Consortium (MU CCTC), one of two groups nationwide recently formed to further research in the area of combat medic training. The two-year grant will allow the MU CCTC to analyze the effectiveness of existing training and make recommendations for how combat trauma care should be performed in the future.

"On the battlefield, combat casualty care provides a challenging and fast-paced environment where diagnostic decisions need to be made quickly," said Stephen Barnes, MD, principal investigator of the MU CCTC and chief of the division of acute care surgery at the MU School of Medicine. "We're optimistic that findings from our studies will improve efforts to save lives and drive development of military medical training for the next decade."

Improving the military medical training required to sustain combat readiness and save lives has become increasingly important over the past decade. Since October 2001, more than 6,000 U.S. service members have died and more than 46,700 service members have been wounded in action as a result of serving in conflicts in Afghanistan and Iraq. At the same time, major medical advances on the battlefield have contributed to the lowest case fatality rates in military medical history.

The MU CCTC will perform research in three critical areas of trauma care: hemorrhage control, airway management and emergency medical skills. Barnes and his colleagues at MU will lead a team of more than 30 civilian and military experts across the country on the research project. The MU CCTC's primary grant partners include the University of Alabama-Birmingham, University of South Florida, University of Central Florida and Information Visualization And Innovative Research, a program and systems management firm in Florida.

The grant will allow the team at MU and its partner institutions to assess and evaluate the effectiveness of existing trauma training methods, such as the use of advanced computerized mannequins. The group will then develop assessment tools and make recommendations to further the training, retention, and competence of medics in pre-hospital combat care settings.

"This competitive grant award represents a significant new initiative for the Department of Defense in military medical training research," said Col. Karl Friedl, PhD, Director of the U.S. Army Medical Research and Materiel Command's Telemedicine and Advanced Technology Research Center. "The elements of this consortium bring together the best of medical training and modern technologies in a convergence science effort that will enable more effective, agile, and affordable options to meet future training requirements."

Using a variety of medical simulation modalities at three university locations, including MU medical school's Russell D. and Mary B. Shelden Clinical Simulation Center, the University of Alabama Birmingham and the University of South Florida, participants will simulate various medical scenarios while receiving feedback in real time. The advanced technology built into the centers' equipment allows them to simulate treatment situations for the three critical research areas, such as airway intubation and treatment of bleeding wounds. The University of Central Florida's Institute for Simulation and Training will independently validate the research. Information Visualization and Innovative Research (IVIR) will provide the industry simulation assessment component.

"With the expertise of the Shelden Simulation Center as well as the simulation expertise of our partner institutions nationwide, we will be able to observe key trauma events and the reactions of our trainees to those events," Barnes said. "This will provide the basis for a new curriculum to train the next generation of combat first responders providing trauma care."

Barnes knows the combat trauma environment well. He spent years teaching lifesaving skills to flight surgeon teams before they deployed into battle. From 2004 to 2008, Barnes served as a major in the U.S. Air Force Medical Corps, where he directed the Critical Air Transport Advanced Training Program at the U.S. Air Force Center for Sustainment of Trauma and Readiness Skills in Cincinnati. In 2006, he served in Iraq as chief of critical care and medical director of the intensive care unit at the 332nd Air Force Theater Hospital at Balad Air Base in Iraq.

Barnes also helps lead MU's Frank L. Mitchell, MD, Trauma Center. As an American College of Surgeons-verified Level I Trauma Center, MU's center meets the nation's highest standards for the comprehensive treatment of patients who require immediate care for serious injuries and illnesses.

"MU has a comprehensive academic health center on a research intensive campus, which gives us the critical mass of expertise and resources we need to lead improvements in medicine at the national level," Barnes said.

The MU CCTC's other contributing partners include: the National Brain Injury Rescue and Rehabilitation Project; Harbor-UCLA Medical Center; Center for Sustainment of Trauma and Readiness Skills in St. Louis, Baltimore and Cincinnati; the U.S. Air Force School of Aerospace Medicine; U.S. Army Medical Department (AMEDD) Center and School; Uniformed Services University of Health Sciences (USU) National Capital Area Medical Simulation Center; Telemedicine & Advanced Technology Research Center; and the U.S. Army Research Development and Engineering Command.





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