Introduction: Prolonged Casualty Care (PCC) refers to delivering medical care in austere environments where evacuation is delayed. In future conflicts, the United States Department of Defense anticipates delays in medical evacuation due to extensive operational areas and challenges associated with operating in semi- and non-permissive environments. This study investigates the impact of a high-fidelity simulation, Operation Gunpowder, designed to teach PCC skills to US military medical students. The simulation emphasizes hands-on experience and leadership within the context of delayed medical evacuation in a limited resource environment. Methods: A qualitative phenomenological design was employed to explore the experiences of 35 third-year military medical students who participated in Operation Gunpowder. Data were collected through pre- and post-simulation interviews and analyzed for thematic insights, first individually coded and then collectively agreed on emerging themes as a group. Results: Three main themes emerged: (1) Benefited from Hands-on Learning: Learners highlighted the importance of practical experience in mastering skills essential for PCC, contrasting it with traditional learning methods. (2) Navigated the Operational Environment: Participants discussed how the simulation exposed them to unpredictable, high-stress scenarios, enhancing their ability to improvise and manage patient care under pressure. (3) Developed Leadership Skills and Abilities: Students recognized their growth and potential in leadership roles, emphasizing teamwork and communication as critical for successful operations. Conclusion: Operation Gunpowder effectively enhanced students’ clinical skills and preparedness for real-world military operations. The simulation fostered hands-on learning, resilience in unpredictable operational environments, and the development of leadership abilities. These findings underscore the necessity for simulation-based training in military medical education, particularly in preparing students for the complexities of PCC in future deployments. Further research will quantify the simulation’s impact on skill performance and explore the integration of telemedicine in austere environments to enhance military medical education.
Tilley et al. (Sun,) studied this question.