JOINT BASE SAN ANTONIO-CAMP BULLIS, Texas, May 13, 2025 – A group of Army Practical Nursing Specialist students and Licensed Vocational Nurses from Brooke Army Medical Center participated in a Phase II Field Training Exercise at JBSA-Camp Bullis April 23-25.
The Phase II FTX is a requirement for 68C (Practical Nursing Specialist) Advanced Individual Training students transferring from Phase I to Phase II.
During Phase I, which is the first stage of a Soldier’s specialized training after Basic Training, 68C candidates receive 11 weeks of classroom instruction as well as practical application of nursing skills, covering topics like basic nursing procedures, patient care, and medical terminology.
Phase II involves specialized, on-the-job training and can range from 12 weeks to three years, depending on the specific training needs of the individual student.
Army Col. Marie Carmona, deputy commander for Inpatient Services, sums up the importance of the practical experience gained during the FTX.
“Classroom knowledge provides the foundation,” said Carmona. “But field training transforms that knowledge into practical skills and prepares a 68C to save lives in a chaotic and dangerous environment. It’s the difference between knowing how to treat a wound and being able to effectively treat (while) managing multiple casualties.”
FTX participant Pfc. Stephanie Berry agrees.
“When you're in the classroom, you know what is coming next, what lecture we are doing,” said Berry. “When you're in the field or training environment, you don't know what different scenarios you might go into, but that's nursing and getting comfortable with the unknown. You never know what you are going to walk into at any given time, you just learn from each experience.”
The FTX, hosted by BAMC’s Department of Hospital Education and Training, was held at the Camp Bullis Deployable Medical Systems Equipment Training site, which recreates deployment conditions, complete with the exact equipment, layout, and operational constraints students will likely encounter in real-world missions.
“(The) Camp Bullis DMSET site offers an exceptional and irreplaceable training environment through its Role 3 (a Role 3 facility provides emergency and specialty surgery intensive care, medical specialty care, and extended holding capacity and capability augmented by robust ancillary support) medical facility setup,” said Army Capt. Anca Schneider, 68C Practical Nurse Program instructor/writer. “This immersive environment creates a unique learning experience that bridges the gap between classroom theory and real-world deployment scenarios, preparing students for the complex challenges they'll face in actual combat support roles.”
The primary focus centered on Individual Critical Tasks competencies and essential Warrior Tasks, ensuring students are prepared for deployment scenarios, which may include – blast injury, burns, and respiratory failure.
These scenarios were chosen for the FTX because they represent the most common injury patterns in deployment settings and were carefully designed to cover critical ICT requirements while aligning with Joint Trauma System Critical Practice Guidelines (CPGs).
CPGs are the backbone of the JTS Performance Improvement program (from https://jts.health.mil/index.cfm/PI_CPGs/cpgs) for combatant command trauma systems and are compiled from Department of Defense Trauma Registry data, health data abstracted from patient records and after action reports. The data is then analyzed and distilled into guidelines to remove medical malpractice variations and save lives. The evidence-based CPGs are used by military and civilian healthcare providers worldwide and are largely responsible for decreasing case fatality rates.
“To maintain authenticity, we incorporated real medical equipment and Class VIII supplies (equipment and consumables), avoiding common simulation pitfalls,” said Schneider. “The training environment combines time pressure, team dynamics, and complex patient care scenarios to recreate ICU conditions, including actual BLS (Basic Life Support) and ACLS (Advanced Cardiac Life Support) situations.”
The scenarios also featured live players as simulated patients alongside traditional training manikins.
“Our hybrid approach utilizes three high-fidelity manikins displaying real-time vital signs, along with six live role-players,” said Schneider. “This combination creates a dynamic learning environment where students must manage both technical challenges and authentic patient interactions.”
Each scenario incorporated unexpected developments based on Mechanism, Injury, Signs, and Treatment (MIST) details, which required students to adapt their care plans rapidly, as they will likely have to do in real-world situations.
Pfc. Owen Oquendo said this approach taught him to be creative with the tools available and to work as a team when caring for patients.
“In class, you have time to think things through,” said Oquendo. “Here, you have to act fast and trust your training and what you have learned.”
The chaotic atmosphere taught Oquendo to focus under pressure.
“During the mass casualty drill, things got chaotic really fast, and I felt a bit lost at first,” he elaborated. “I reminded myself to focus on what’s important, take it one step at a time, and work with my team.”
According to AIT student Spc. Omaria Leon, teamwork is paramount to treating patients quickly.
“Working as a team during the FTX helped us move quicker and more efficiently,” she said. “All the skills that were displayed will help us save someone’s life.”
Leon stated the exercise sharpened her prioritization skills and boosted her confidence.
“The most important thing I learned to do was prioritize,” she said. “I am now more confident in my ability to work under pressure.”
In addition to providing practical experience, the FTX is also designed to enhance military readiness for participants.
“Maintaining a high level of military readiness for the 68C requires rigorous field training that goes beyond classroom instruction,” said Carmona. “Real-world battlefield injuries rarely present as textbook cases. Consistent, hands-on practice in the field is essential for developing the muscle memory needed to perform critical life-saving skills – such as IV insertion, airway management, wound packing, and splinting – effectively and efficiently when every second matters.”
“Furthermore, field training cultivates adaptability and resourcefulness,” she continued. “Soldiers learn to improvise treatment strategies and utilize limited resources when a fully stocked medical kit or ideal treatment location isn’t available. This ability to ‘think on their feet’ and maintain composure under pressure is paramount to ensuring mission success and maximizing casualty survival rates, directly contributing to overall unit readiness.”
Carmona underscored the importance of Soldiers being able to think quickly under pressure.
“Ultimately, we need Soldiers to make sound medical judgments under pressure and when facing ambiguous situations,” she said. “They must adapt to changing circumstances, creatively solve medical challenges, and take initiative without waiting for direction.”
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