Being Outside the Contiguous United States (OCONUS) location poses many challenges to the units that operate so close to potential contingencies and need to maintain their critical skillsets. Shipping and manufacturing restraints and realistic budgeting do not allow for many of the shared resources and training the Contiguous United States (CONUS) locations can coordinate. That is when the leaders and SME’s come together to design training to help fulfill the training requirements that keep our healthcare providers ready to provide lifesaving care even in the most austere environments.

Cdr. Aparicio explained why she wanted to develop this Basic Facilitator Simulation for Healthcare Course from the usual two-day course to a more consolidated one-day event. Aparicio said, “I wanted to strengthen first responder preparedness and promote excellence in pre-hospital and en route care training, so a one-day simulation facilitator course was developed and delivered to a cohort of novice educators from MCIPAC Fire & Emergency Services from Kadena, Tori EMS Stations, and U.S. NMRTC Okinawa. Rooted in the Healthcare Simulation Standards of Best Practice™ published by the International Nursing Association for Clinical Simulation and Learning (INACSL), the course addressed a regional gap in simulation-based education for emergency medical technicians (EMTs) and paramedics.

Being the largest OCONUS Military Treatment Facility (MTF) serving a population of over 58,000 enrolled and being the referral center for an additional 189,000 USNHO provides many distinctive and unique opportunities for Corpsmen assigned to the hospital. One distinct opportunity is becoming EMT trained and manning one of 8 ambulances positioned throughout the island at branch clinics and the hospital. Maintaining an active roster of EMTs and instructors to teach them is a very challenging requirement. One of the instructors, Lt. Juniper, said, “This helps bridge the gap between the ability to do and to teach.” The idea is that a very competent clinician has the skills to perform the tasks of an EMT but might lack the formal training needed to be a qualified instructor. Juniper said, “The hands-on training helps the skilled providers become more effective in sharing their expertise.” Hands-on sessions were conducted in a high-fidelity simulated ambulance environment, allowing participants to facilitate and debrief a realistic trauma and transport scenario. This immersive experience reinforced the principles of safe learning environments. It allowed facilitators to model clinical excellence while addressing operational challenges unique to en-route care.

Designed with the unique needs of the pre-hospital providers in mind, the course curriculum emphasized experiential learning and faculty development. The participants were introduced to foundational concepts, including scenario design, psychological safety, effective pre-briefing and debriefing techniques, and learner-centered facilitation strategies. The course highlighted simulation’s critical role in improving clinical decision-making and team communication during high-stakes, low-frequency events in field settings.

By the end of the day, participants demonstrated increased confidence in their ability to lead simulations that advance readiness, reduce variability in emergency care delivery, and enhance clinical competency in austere environments. Participants left feeling more confident in their ability to lead simulations. They requested more time for hands-on practice and scenario development. This course represents a scalable model for regional simulation faculty development that empowers first responders to become educators, advocates for safe practice, and forces multipliers in their communities.

The U.S. Navy Medicine Readiness and Training Command Okinawa (USNMRTCO) supports the Defense Health Agency's U.S. Naval Hospital, Okinawa (USNHO) as the largest OCONUS Navy Medicine medical treatment facility and stands at the ready to respond to contingency operations to support the INDOPACOM region. It is a critical regional asset for direct care delivery, regional referrals, and medical contingency operations. The staff of USNHO understands their vital role as pre-positioned, forward-deployed naval forces within the first island chain, aligned and in support of the joint military commands and operations.