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INTRODUCTION

Congratulations on your selection to teach the 081-6-8-C40 (91B30 Technical Training) Basic Noncommissioned Officer Course (BNCOC) Phase 4, Total Army Training Course. As a course manager or instructor, you will coordinate and/or train Sergeants and Staff Sergeants in critical advanced emergency trauma treatment skills to qualify for promotion to Sergeant First Class.

The purpose of the Course Management Plan is to provide guidelines for establishing a BNCOC 91B30 Technical Training exportable training program. In order to be flexible enough to allow each program to adapt to the capacity of the individual training site, the guidance provides minimum standards. This plan will inform you of the materials that have been prepared by the U.S. Army Medical Department Center and School (AMEDDC&S) and explain how the materials are intended to be used.

This document will attempt to answer as many questions and to address as many of the training problems that may be unique to the RC as possible. As a course manager, you will have to make decisions based on your experience and research of the various unit-oriented situations that may impact on the training of the 91B30 BNCOC. The AMEDDC&S is proponent for the course and will monitor and provide guidance and assistance as needed to ensure that medical doctrine, standardization, and credibility of the school is maintained. The course manager will ensure that the quality of 91B30 BNCOC graduates is in keeping with the highest standards as set by the AMEDDC&S, the AMEDD and the U.S. Army.

The Phase 4, 91B30 BNCOC is designed to follow the Phase 3 self- study. All potential Phase 4, 91B30 BNCOC attendees MUST complete the Phase 3 self-study prior to attending Phase 4. The Inactive Duty Training (IDT), Phase 4, consists of five IDTs.

To obtain authorization to become a training site for the Phase 4, 91B30 BNCOC, address correspondence thru your Health Services Brigade to Commander, AMEDDC&S, ATTN: MCCS-HSN, Fort Sam Houston, Texas 78234-6199. Correspondence must include instructor qualifications and assurance that classroom facilities, supplies, and equipment are available.

The Commander, 232d Medical Battalion, is the Course Director/monitor of the 081-6-8-C40 (91B30 Technical Training) BNCOC Phase 4 Program of Instruction (POI) at the AMEDDC&S. The quality of instruction, adherence to lesson plans, evaluation procedures, and final product rests with the commander and medical personnel within the RC teaching unit/organization. TASS School Battalion site visits by AMEDDC&S personnel for the purpose of direction or clinical consultation will be both encouraged and permitted. Each TASS School Battalion unit selected to instruct the Phase 4, 91B BNCOC POI will appoint a local course manager.

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Questions of an administrative nature, to include inquiries about correspondence course or resident course materials or authorization to teach should be addressed to the Chief, Nonresident Instruction Branch, Commercial (210) 221-5877; DSN 471-5877; or Toll Free 1-800-344-2380; or write to Commander, AMEDDC&S, ATTN: MCCS-HSN, Fort Sam Houston, TX 78234-6199.

INSTRUCTOR QUALIFICATIONS

The course manager must be an AMEDD officer. To effectively teach this course and monitor the progress of the students, all instructional staff will be members of the AMEDD. Ideally, officers and enlisted personnel instructing materials in the Phase 4, 91B BNCOC should present formal blocks of instruction in their areas of expertise.

For clinical sessions, a physician, nurse, or a qualified senior NCO should be assigned direct responsibility for the activities of the students. The goal of the AMEDDC&S is to have a minimum of 75 percent of the program of instruction taught by senior NCOs. Instructor qualifications are listed below.

Minimum Instructor Requirements

  • - Meet height and weight standards of AR 600-9.

  • - Meet APFT standards within the last 12 months IAW AR 351-1 and FM 21-20.

  • - Meet the same physical standards as students for the course they will instruct AR 611-201.

  • - Be a graduate of the Instructor Training Course (ITC) or Battle Focused Instructor Training Course (BFITC) within 5 years.

  • - Be a graduate of Small Group Instructor Training Course (SGITC).

  • - Hold the SQI “H” (enlisted); SQl “8” (warrant officer) or SI “5K" (commissioned officer).

  • - Meet the minimum Instructor Qualification Requirements as listed in appropriate regulations: TRADOC PAM 350-15, TRADOC Reg 351-70, and FORSCOM/TRADOC Reg 135-3.

Proponent-Specific Qualification Requirements for Phase 4, 91B30 BNCOC

  • - SSG (E6) or above, holding MOS 91B or 91C, Practical Nurse, Physician Assistant, Army Nurse Corps Officer, or Medical Corps Officer.

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  • - Experience in emergency medical treatment skills or critical care nursing within the last five years.

  • - Enlisted instructors must be a graduate of Phases 3/4 91B or MOS 91C BNCOC. (Soldiers who have converted to MOS 91B at the E-8 level must have attended the MOS 91B10, Medical Specialist Course and MOS 91B BNCOC technical training. Attendance of 91B ANCOC alone does not qualify an instructor to teach the Phase 4, 91B BNCOC.)

  • - All instructors must be at least Basic Life Support (BLS) Provider certified. At least one instructor must be BLS- Instructor certified.

The course manager, through credentialing action, will ensure that instructors meet the above prerequisites prior to presenting any formal blocks of classroom instruction. In addition, instructors must know how to operate all of the equipment required for the course, including audiovisual, training aids, etc. Utilization of guest speakers is encouraged in order to place emphasis on specific training areas. Instructor qualifications along with other administrative procedures required to conduct training programs will comply with appropriate AMEDDC&S regulations.

INSTRUCTOR RECERTIFICATION

Instructors must be recertified before continuing duties as a primary instructor if:

  • - Previous instructor certification was issued during a fiscal year more than five years prior to the current fiscal year.

  • - Instructor has not performed duties as primary instructor in the topic for more than 36 consecutive months.

CARDIOPULMONARY RESUSCITATION (CPR)

All students are required to have CPR certification prior to entering training in the Phase 4, 91B30 BNCOC. Individual site course directors should make arrangements to certify students and instructors in CPR with the Military Training Network for Resuscitative Medicine Programs, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, Maryland 20814- 4799 to obtain a site code and CPR certification cards. Site instructors must be CPR-Instructor certified to administer CPR certification training.

ORGANIZING THE COURSE

Before actually presenting the course, you must accomplish a number of things. These actions will depend upon the specific circumstances under which you will be conducting the course.

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Inventory the Course Materials. Upon receipt of the course materials, you should inventory them to ensure everything is there. If there are items missing, you must order them immediately. The course manager’s packet should contain the following:

Course Management Plan

___________

Instructor Packets of Lesson Plans

___________

Written and Performance Test Booklets

__________

___________

Answer Keys

Supportive Audiovisual Aids

___________

___________

Student Mimeos

Secure Test Material. Tests, written and performance, and answer keys must be safeguarded. The school battalion will adhere to regulatory guidance listed in AR 611-5, Chapter 2 and FORSCOM/TRADOC Reg 350-7.

Arrange for Classroom Facilities. Select classrooms that will provide adequate space to accommodate the anticipated student load. Also, consider necessary space for conducting practical exercises and performance tests, as well as the type of audiovisual equipment/training aids to be used.

Arrange for Any Audiovisual Equipment You Will Need. You will want to determine where you will obtain it and how you will transport it to the training site.

Arrange to Obtain Videotapes. The videotapes mentioned in the lesson plans may or may not be available. Using videotapes is for enhancement and is not mandatory.

Reference Materials. Military and civilian references are found in Appendix B.

Consider Student Load. You should consider the number of instructors needed based upon the number of students and the type of instruction. Instructor: student ratio for didactic instruction is l:

Class; however, for performance practice and testing, a 1:6 ratio is recommended. Written examinations require two proctors at all times.

CONDUCTING THE COURSE

Conduct of the course will depend upon specific school circumstances. You must be adaptable and innovative and use the method that works best for you. Modules must be taught in sequence to ensure progressive learning. From the start of the course, you must maintain student records.

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Student Orientation. A proper orientation sets the tone for the course and lets the students know what is expected of them. The orientation should provide the following:

-- Explanation of course purpose and contents. -- Explanation of written test and practical exam administration. -- Review of the Student Evaluation Plan

COURSE RECORDS

Student records must be maintained from the beginning of the course. As you administer a test, record the grade attained and date taken by each student on the appropriate record-keeping document. Retests should be recorded in the same block as the original test score.

Course Diplomas: All records must be completed and forwarded to the Nonresident Instruction Branch with a completed Roster of Graduates when all course requirements have been completed. Upon verification the graduate roster will be used to prepare diplomas. The diplomas will not be prepared until all documents have been verified.

Instructor Certification Records: Instructors must complete all instructor certification requirements before performing duties as a primary instructor.

Students must be counseled as required in the Student Evaluation

Plan.

The following records must be completed and forwarded to the Nonresident Instruction Branch upon completion of training:

  • 1. 91B BNCOC Self-Study Plotter - Annex Dl to D2

  • 2. 91B BNCOC IDT Progress Plotter - Annex D3

  • 3. Roster of Graduates - Annex E

  • 4. Instructor Certification Checklist - Annex F

  • 5. Instructor Verification Sheets - Annex F

  • 6. Oral Presentation Evaluation - Annex F

  • 7. Record of Student Counseling - Annex G

LESSON PLANS AND STUDENT MIMEOS

Student mimeos have been developed to be mirror images of instructor lesson plans with the exceptions of audiovisual

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entries and notes that are specifically for the instructor. Annexes in the student mimeo will maintain the same annex letter that is in the instructor lesson plan. In other words, Annex A in the lesson plan may contain the Instructional Aids - Slides listing and Annex B may contain a drawing of the musculoskeletal system. The student mimeo annex section will begin with Annex B and will contain the drawing of the musculoskeletal system. Students should be informed that with one or two exceptions, Annex A will not be used in the student mimeo. This is to avoid the confusion of annex identification differing from the student mimeo. Fill-in-the-blanks have also been eliminated from the main body of the student mimeo.

TESTING PROCEDURE

Each module consists of a written test, written performance test, and/or performance test. The minimum passing score on the written test is 70 percent. Performance tests are scored GO or NO-GO. To administer a test for a module, remove the test from the test booklet and give it to the student. There are two versions of each test. To lessen the possibility of compromising the test, you should issue alternate versions to the students and not allow them to retain graded tests.

Instructions are on the written tests to tell the students how to take the test and what tasks are covered. Each performance test includes instructions for the instructor as well as the student. Upon completion of the test, you should grade it and provide each student with immediate feedback on his performance. Discuss with the student the things he did well and those he did poorly.

If the student receives a NO-GO on his first test, you must attempt to determine why and assign additional study to correct the problem. Then, if the student receives a NO-GO on his second test, counsel him to determine the nature of his learning difficulty. The difficulty may be caused by:

-- Reading problems -- Personal problems -- Lack of interest -- Unsuitability for MOS -- Lesson difficulty or deficiency

After counseling the student, you may or may not allow him to continue the course, depending on the cause of his problem. If you feel the student cannot successfully complete the course, you should notify his unit that the student is failing. The unit commander will then decide whether to allow the student to continue the course or to offer him another MOS in the unit.

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PRACTICAL SKILLS TRAINING/TESTING

Training and testing of hands-on skills are essential in assuring competence of the Phase 4, 91B30 BNCOC student. Adherence to established standards throughout the program will maximize the potential for accurate preparation and measurement of the student’s ability to perform required tasks. Universal precautions should be maintained at all times. The use of gloves should be practiced when appropriate.

While adaptation to accommodate local personnel and equipment resources may be necessary, deviation from performance standards is not authorized. Student ratios for instructors and equipment, which are described in the POI, must be met through creative structuring of schedules and classroom configuration, not by reducing requirements for satisfactory execution of skills.

PERSONNEL

One or more subject matter experts (SME) will be identified for each hands-on skill. The SME will assure standardization of training and testing by demonstrating performance steps to all instructor personnel prior to the scheduled class, and by periodic monitoring of classroom instruction and testing.

EQUIPMENT

All equipment must be checked for serviceability prior to training. Frequently-required replacement parts, such as batteries and light bulbs, should be ordered and maintained on-site to avoid loss of training time. Civilian-procured items may be substituted for identified military issue equipment as needed if performance requirements are not compromised. The equipment list for implementation of training is found in the POI.

TRAINING SCHEDULES

When developing training schedules, POI modules should be scheduled sequentially. It is recommended that a practical exercise for a skill should be scheduled as soon after the associated lecture/demonstration/review as possible. Scheduling morning lectures with afternoon hands-on practice is generally effective.

Hours designated in the POI for practical exercise are per Student; each student must be afforded the opportunity to practice the designated skill for the total number of POI hours allotted for that skill. However, the hours designated for hands-on practice are

also governed by the numbers of students in a class. This POI is based on a maximum class size of 60 students. If for example, you have a class of 20 students, practical exercise and exam periods of instruction should be adjusted accordingly, ensuring that all students receive the maximum training time needed to perfect the

task.

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The following is a recommended training schedule for Phase 4 training:

 

IADT #1

HOURS

SATURDAY

2

Components of a Physical Assessment

2

IV Therapy

3

Blood Components

2

NG Intubation-practical Exercise/Demonstration

9

TOTAL

SUNDAY

2

Patient Assessment Practical Exam

3

IV Therapy/Blood Component Practical Exam

2

NG Intubation Practical Exam

7

TOTAL

IADT #2

SATURDAY

1

Airway Management Review

4

Airway Management Practical Exercise

2

Airway Management Practical Exam

1

Emergency Cardiac Management Practical Exercise

8

TOTAL

SUNDAY

2

Emergency Cardiac Management Practical Exercise

1

Automatic External Defibrillator (AED) Conference

2

Automatic External Defibrillator. (AED) Practical Exercise

3

AED Practical Examination

8

TOTAL

IADT #3

SATURDAY

HOURS

3

Wound Closure/Suturing

6

Emergency Surgical Procedures Didactic/PE

9

TOTAL

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SUNDAY

2

Wound Closure/Suturing Practical Exam

1

Introduction to Trauma Management

1

Motion Injury

1

Assessment & Initial Management of the Trauma Patient

1

Initial Airway Management

1

Abdominal Trauma

1

Chest Trauma

8

 

IADT #4

SATURDAY

1

Shock Evaluation and Management

1

Spine Management

1

Head Trauma

1

Extremity Trauma

1

Burns

1

Trauma and Pregnancy

1

Trauma in Children

1

Fluid Resuscitation Skills

1

Urinary Catheterization

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SUNDAY

3

Scenario Practice

2

Field Evaluation

3

Skill Stations

8

 

IADT #5

SATURDAY

2

Urinary Catheterization Practical Exam

1

Written Exam

1

Written Exam Review

3

Scenario Testing

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CLASSROOM CONFIGURATION MANAGEMENT

For tasks which require more than one participant, such as CPR, students will rotate positions within the group for both training and testing. Each student will be evaluated for skill proficiency only while performing in the role of the care provider. The student being evaluated will provide all direction for those in the roles of support personnel; the student evaluation requirements include an assessment of the accuracy and completeness of these directions.

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Practical exam testing areas will be structured to prevent observation of the testing process by other than those directly

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involved in performance of skill. Partitions may be used to create multiple testing areas if individual rooms for each station are unavailable. The individual being tested, support personnel, and the evaluator will be the only authorized personnel in the testing area.

Test sheets will be controlled and issued only on the day of testing , distribution, scoring, and turn-in procedures will be developed to preclude alteration or destruction of the score sheet, and unauthorized retesting of the students.

Standardization in training and testing of all hands-on skills is critical. Implementation of all aspects of the POI IAW established standards will maximize the instructional process and the quality of medic produced by this program.

QUESTIONNAIRE

In order to further support you and to improve the quality of training, we request that you complete and return the enclosed questionnaire in Annex H after you have administered the course. If you have problems or questions about the course, do not wait until the end of the course to contact us. The Chief, Nonresident Instruction Branch will serve as the collection agency for all completed AMEDD end-of-course surveys and questionnaires. Completed AMEDD end-of-course surveys should be mailed to:

Commander U.S. Army Medical Department Center and School

ATTN:

Chief, Nonresident Instruction Branch

2105 11th Street Fort Sam Houston, Texas 78234-6199

SUSTAINMENT/REINFORCEMENT TRAINING

Sustainment training for MOS 91B soldiers is available in correspondence course format. To obtain a recent list of available courses, soldiers should review DA PAM 351-20. Courses are available through the Nonresident Instruction Branch, AMEDDC&S.

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