Att_33_MSTC CPD.pdf

UNCLASSIFIED

Final v4_2, generated on 09/07/2018

Capability Production Document

For

(U) MEDICAL SIMULATION TRAINING CENTER (MSTC) PROGRAM

Increment 1, Revision 1

Sponsoring Agency: US Army

Signature Authority: GEN James C. McConville, VCSA

Date Submitted: 10 September 2018

Primary & Secondary POCs Name Title/Position Phone Email Dr. Hank Gardiner Head, JCIDS Capability

Document Cell, CDID, AMEDDC&S, 2377 Greeley Road Ft Sam Houston, TX 78234

210-295-0531

DSN 421

NIPR: chris.h.gardiner.civ@mail.mil SIPR: chris.h.gardiner.civ@mail.smil.mil

Mr. Steven D. Behel Chief, Distribution and Sustainment Branch, Sustainment Division, ARCIC, 950 Jefferson Avenue, Fort Eustis, VA 23604

757-501-5544

DSN 501

NIPR: steven.d.behel.civ@mail.mil SIPR: steven.d.behel.civ@mail.smil.mil

Proposed Validation Authority: US Army

Proposed MDA: Program Executive Office for Simulation, Training, and Instrumentation

Proposed JSD: Joint Information

Proposed ACAT: III

CARDS # 2551

Date Revision 1 approved: 6 March 2019

Releasability: Distribution authorized to the Department of Defense (DOD) and DOD contractors only. Relevant information may be released to foreign entities when appropriate export authorization documentation accompanies the request for release and this documentation has been verified by the United States (US) Government. Other requests will be referred to AMEDDC&S, HRCoE, CDID, Attn: Dr. Hank Gardiner, 2377 Greeley Road, Fort Sam Houston, TX 78234

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(U) Validation Page

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(U) Executive Summary

This revision of the approved capability production document (CPD) for the Medical Simulation Training

Center (MSTC) Program offers a standardized, exportable Tactical Combat Casualty Care TC3 (TC3X) capability utilized to train Soldiers on Warrior, individual, leader, and collective medical tasks of the

Operational Force every 2 years. The Army Warfighting Challenges (AWFCs) are as follows: 6. Conduct

Homeland Operations; 8. Enhance Training; 9. Improve Soldier, Leader & Team Performance; 10. Develop

Agile & Adaptive Leaders; and 16. Set the Theater, Sustain Operations, & Maintain Freedom of Movement.

All AWFCs contribute to the Soldier's ability to perform basic medical skills on the battlefield.

The MSTC was established by an Operational Needs Statement (ONS) by The Commander, U.S. Army

Medical Command, in 1 September 2005, which identified a gap in Soldier medic training. The ONS listed the gap as the difference between current training offered and the need for battle-focused training utilizing the principles of providing care in a tactical combat environment found in TC 8-800. It noted that there were no dedicated resources for the sustainment of combat medic skills after Soldiers complete Advance Initial

Training (AIT). Sustainment and enhancement training for the Soldier medic was not standardized and was inconsistent from installation to installation. The ONS also noted that valuable lessons learned from OIF and

OEF are not passed on uniformly to Soldiers. The MSTC Program filled the training gap identified in the

ONS.

In 2009, a capability production document (CPD) was formulated and approved to make the ONS an enduring capability and expanded the MSTC program to 16 sites. In FY24, the MSTC Program will reach full operational capability (FOC) when 25 MSTCs are fielded. In addition to training combat medics, it provides Combat Lifesaver (CLS) training to non-medical personnel assigned to units that lack medical personnel. The MSTC Program offers a standardized training platform for training Tactical Combat

Casualty Care (TC3), Training Circular 8-800, Medical Education and Demonstration of Individual

Competence (MEDIC), and Combat Life Saver (CLS) Programs of Instructions (POIs). The MSTC provides a capability that is not currently available in the United States (US) Army Medical Department (AMEDD), Forces Command (FORSCOM), or in Training or Doctrine Command (TRADOC) structures. This is a centralized learning capability, utilizing a system designed to support the sustainment and the validation of medical skills in accordance with training circular (TC) 8-800, and CLS POIs. In addition, the MSTC

System serves as a platform where lessons learned from current military operations are implemented and where Soldiers are educated on new battlefield medical procedures and equipment. The MSTC and TC3X

Programs rely on the U.S. Army Installation Management Command’s effort to executive and manage installation training, U.S. Army Medical Command’s medical supply resourcing for training execution, U.S.

Army Medical Department Center and School (AMEDDC&S), Health Readiness Center of Excellence’s

(HRCoE) proponent responsibilities, training curriculum and oversight of the National Emergency Medical

Technician requirement, and Program Executive Office Simulation Training Instrumentation’s ability to provide performance-oriented training to Soldiers.

And now, with the Revision 1 of the approved CPD, the MSTC Program will expand its scope and ensure that additional Army personnel receive needed Warrior training and improve medical task readiness.

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(U) Table of Contents

(U) Validation Page ....................................................................................................................................... i

(U) Executive Summary ............................................................................................................................... ii

(U) Table of Contents .................................................................................................................................. iii

1 (U) Operational Context

1.1 (U) Validated Source Document Citation

1.2 (U) Operational Context Summary

2 (U) Threat Summary

2.1 (U) Threat Assessment Citation

2.2 (U) Threat Summary Outline

3 (U) Capability Discussion

3.1 (U) Validated Capability Requirements Overview

3.2 (U) Related Analysis and Studies Summary

3.3 (U) Supported ICDs and Related CDDs/CPDs/Joint DCRs

4 (U) Program Summary

4.1 (U) Program Strategy

4.2 (U) IOC and FOC Definitions for the current increment

5 (U) Production KPPs, KSAs, and APAs

5.1 (U) Mandatory KPPs

5.2 (U) Additional KPPs, KSAs, or Attribute

5.3 (U) KPP/KSA/Other Attributes Rollup

6 (U) Other System Attributes

6.1 (U) Embedded Instrumentation, EA and WARM requirements

6.2 (U) Human System Integration

6.3 (U) Natural Environmental Factors

6.4 (U) Physical and Operational Security

6.5 (U) Weather, Oceanographic, and Astrophysical Support

6.6 (U) Transportability and deployability considerations

6.7 (U) SWaP-C margin requirements/open systems attributes

7 (U) Spectrum Requirements

7.1 (U) Electromagnetic Environmental Effects (E3) Summary

7.2 (U) Spectrum Summary

8 (U) Intelligence Supportability

9 (U) Weapon Safety Assurances

10 (U) Technology Readiness

10.1 (U) Technology Challenges

10.2 (U) Technology Readiness Assessment

11 (U) DOTmLPF-P Considerations

11.1 (U) Doctrine

11.2 (U) Organization

11.3 (U) Training

11.4 (U) Materiel

11.5 (U) Leadership

11.6 (U) Personnel

11.7 (U) Facilities

11.8 (U) Policy Issues

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12 (U) Program Affordability

12.1 (U) Life Cycle Cost Analysis Citation

12.2 (U) Summary of Resources Required

(U) Appendix A: References

(U) Appendix B: Acronyms

(U) Appendix C: Glossary

(U) Supporting Documents (Separate File)

(U) Revision History

Version Date Purpose v3_2 02 Jun 16 ARCIC validation review Revision 1 to the approved CPD v3_3 15 Jul 16 ARCIC validated, submitted for HQDA Staffing v3_4 12 Sep 16 Update incorporates HQDA staffing comments, submitted for AROC review and approval v3_5 9 Mar 17 Update incorporates TRADOC CAC T comments submitted to HRCoE review and approval v3_6 10 May 17 Updated document incorporates DASA-CE comments submitted to ARCIC

V3_7 24 Aug 17 Updated document incorporates subsequent DASA-CE comments; submission to ARCIC

V3_8 11 Dec 17 Updated document incorporates additional DASA-CE comments; submission to ARCIC

V3_9 05 Jan 18 Updated document incorporates update to IOC and FOC, as well as additional DASA-CE comments

V3_10 16 Jan 18 Updated document incorporates updates to operational life (FY39).

V3_11 09 Feb 18 Updated document incorporates clarifying edits per HQDA OSA-OBT comments on the C-

BA.

V3_12 20 Feb 18 Updated document incorporates further clarifying edits per HQDA OSA-OBT and DASA-CE comments on the C-BA.

V4.0 19 April 2018 Updated for AROC review.

V4.1 06 June 2018 Updated for AROC review.

v4_2 07 Sep 18 Update incorporates comments from the 2nd limited HQDA staffing that preceded the ARB return 18 Sep 18. Submitted final for approval

(U) Other Points of Contact

Name Title/Position Phone Email LTC Robert Carter Product Manager, MEDSIM, MSTC

U.S. Army PEO STRI 12350 Research Parkway Orlando, FL 32826-3276

(407)384-3905

DSN 970

NIPR: robert.carter422.mil@mail.mil

LTC Justin Avery Chief, AMEDD Warfighting and Experimentation Division, CDID, HRCoE 2450 Stanley Road JBSA/Fort Sam Houston, TX 78234

(210)295-0523

DSN 471

NIPR: justine.avery1.mil@mail.mil

MAJ Charles Densevich Chief, MSTC Programs U.S. Army EMS PM 2450 Stanley Road JBSA/Fort Sam Houston, TX 78234

(210)221-0837

DSN 471

NIPR:

charles.w.densevich.mil@mail.mil

Mr. Christopher Holmes CAC-T, ATSC/TSAID Operations Research Analyst, TRADOC 1900 Jackson Street Fort Eustis, VA 23604

(757)878-0684 NIPR:

christopher.p.homes.civ@mail.mil mailto:robert.carter422.mil@mail.mil mailto:justine.avery1.mil@mail.mil mailto:charles.w.densevich.mil@mail.mil mailto:christopher.p.homes.civ@mail.mil

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1 (U) Operational Context

1.1 (U) Validated Source Document Citation

This capability production document (CPD) is part of a family of systems (FoS) as stated in the Theater

Combat Casualty Care (TC3) Initial Capabilities Document (ICD), approved 05 October 2007 by

Headquarters Department of the Army (HQDA) G3, Catalog of Approved Requirements Documents

(CARDS) number 16134 and the Medical Simulation Training Center (MSTC) Program CPD Increment 1 approved by HQDA G3 on 23 June 2009, CARDS number 2535.

1.2 (U) Operational Context Summary

Figure 1-1 OV-1 High Level Operational Concept Graphic of the MSTCs.

2 (U) Threat Summary

2.1 (U) Threat Assessment Citation

2.1.1 (U) Most current DIA or Service validated threat analysis

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For Defense Intelligence Agency (DIA) approved threats see Computer Network Operations Capstone

Threat Assessment (IO Capstone Volume 10), DIA-08-1111-548, January 2013: the Land Warfare Capstone

Threat Assessment, NGIC-1141-0412-11, dated April 2011, and the Chemical, Biological, Radiological, and Nuclear Warfare Capstone Threat Assessment, DIA-05-0909-027, February 2016.

2.1.2 (U) Threat support provided by Army Medical Department Center and School (AMEDDC&S) and

Training and Doctrine Command (TRADOC), G2.

2.2 (U) Threat Summary Outline

No Critical Intelligence Parameters (CIPs) have been developed for the MSTCs.

2.2.1 (U) Threats to be Countered

The MSTCs are medical training platforms and are not intended to counter a threat; rather, they train

Soldiers to respond to trauma caused by threat systems and actions.

2.2.2 (U) System Specific Threats

The MSTC system will be subject to information operations threats, primarily from computer network operations including viruses, hackers, insiders, and unauthorized users. The MSTC system could also be subject to the entire array of physical attack threats ranging from blast and fragmentation effects from direct and indirect fire weapons and improvised explosive devices (IEDs) to CBRN contamination in CONUS locations or deployed, although it is unlikely that it would be specifically targeted. Radiofrequency directed energy weapons could also be employed against MSTCs at short ranges.

2.2.3 (U) Operational Environment

Through 2025 the United States (US) military will remain globally engaged into the foreseeable future and will be called upon to execute missions across the spectrum of conflict. Many crises will start locally or regionally, but due to ethnic, tribal, and/or religious affiliations and due to globalization and greater access to new, evolutionary and revolutionary technologies, could rapidly and unexpectedly expand to involve more than one country, type of combatant, and/or non-state element. US forces will employ intelligence functions in the full range of operational environments to include urban environments. Potential enemies will exploit terrain, weather, and civil considerations to create asymmetries and gain the tactical advantage by negating or offsetting US technological advantages. Civilian populations, if they are not themselves actively supporting the adversary's military, will be used as early warning systems, obstacles, targets, camouflage, and sanctuary providers to shape and/or distort the battlefield. The enemy will optimize their forces and capabilities for the physical and/or cultural terrain and circumstances. Enemy forces are likely to be hybrid threats, consisting of a diverse and dynamic combination of regular forces, irregular forces, and/or criminal elements all operating in an integrated manner to achieve mutually benefitting effects. Easy access to new technology allows enemies the potential to achieve equality to, or even overmatch, US systems in selected niche areas. The most stressing operational threat is a nuclear-armed nation with technologically enhanced conventional military supported by sub-state and non-state actors. The most likely operational threat will be combinations of threats employing low, high, improvised, and niche technologies, empowered by cyber and space.

3 (U) Capability Discussion

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3.1 (U) Validated Capability Requirements Overview

This revision of the approved MSTC capability production document (CPD) addresses the need for the expansion of the MSTC program to provide an exportable capability [to be referred to as the Tactical

Combat Casualty Care (TC3) Exportable or just TC3X] utilized to train Soldiers on realistic casualty

Warrior skills training at the individual, leader, and collective level to the Operational Force.

3.1.1 (U) Overview of Capability Gap. The TC3Xs will be procured and sustained by Program Executive

Office for Simulation, Training, and Instrumentation (PEO STRI) and placed at various Training Support

Centers (TSCs). TCSs will hand receipt the TC3Xs to Soldiers where they will be utilized to train Soldiers on Warrior, individual, leader, and collective medical tasks of the Operational Force every 2 years on a rolling basis. Soldier Medics will train at the MSTC to develop “train the trainer" skills necessary to train

TC3X.

3.2 (U) Related Analysis and Studies Summary

3.2.1 (U) Analysis for System Training Key Performance Parameter.

3.2.1.1 (U) Each MSTC must have the capacity to train 2,500 Soldiers annually. This figure was calculated partially based on an Army-wide population of approximately 34,000 Combat Medics (68W) in 2005. IAW

Army Training Circular 8-800, Annual Combat Medic Skills Validation Test, every 68W is required to recertify their hands-on skills annually. Assuming a roughly even distribution across the 25 MSTCs, this equated to 2,125 Combat Medics per site. The remaining 375 Soldiers to be trained was built into the figure to provide the MSTC the capability of training a limited number of Soldiers with the Combat Life Savers training annually for those units lacking organic medical personnel.

3.2.1.2 (U) These numbers are based on an analysis of how many trainees an instructor can be in charge of in a group (i.e., 30 students per instructor for classroom; six per for hands on; one per for invasive), taking into consideration how many groups can go through an MSTC per week, multiplied by number of training weeks in the year.

3.2.1.3 (U) The total of 2,500 is the most economically supportable maximum throughput per standardized system based on demographics of trainee populations without getting unmanageable. It is the best “balance point” for a system. More throughput capability would mean wasted capability at lower population density areas; lower capability would mean not meeting training requirements of higher density areas.

3.2.2 (U) Standardization: There remains a lack of standardization across the US Army in terms of instructor proficiency. The proficiency of individual unit level trainers varies by installation and organization. This lack of proficiency and standardization often leads to Soldiers inadequately trained or receiving outdated training, or both. The MSTC using proponent developed doctrinal training material provides standardized training to combat medics and combat lifesavers. TC3X complements the MSTC where combat medic non-commissioned officers will receive proponent train the trainer courses (instructor courses) from MSTC instructors on use of TC3X devices for Individual Soldier Warrior Tasks and TC 8-800 task sustainment and validation instructor training.

3.2.3 (U) Simulation equipment: Units purchasing simulation equipment generally fail to purchase the maintenance service plan that accompanies simulation equipment. Organizations cannot adequately frank.stroud Highlight frank.stroud Highlight

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maintain simulation equipment due to lack of funding and qualified maintenance technicians. This resulted in thousands of dollars of simulation equipment stored, coded unserviceable, or discarded. Also, units lacked the expertise to operate complex simulation equipment resulting in multifunctional simulators used for rudimentary medical tasks. Furthermore, the lack of expertise in terms of operating the simulation equipment, lead to unrealistic training scenarios, which in turn, enforced negative medical practices on medics and CLS personnel.

3.2.4 (U) Validation: Prior to the MSTC Program, unit commanders had no method of receiving an independent validation of their medical operational posture. Previously, medical training, sustainment, enhancement, and validation were internally conducted. An independent entity did not exist that could validate an individual medical/CLS in terms of “fully qualified” medically to complete his/her combat tasks.

3.2.5 (U) Lessons Learned: TRADOC’s Combined Arms Center’s for Army Lessons Learned does not currently capture real world wound data and subsequent physiological casualty impacts. The U.S. Army

Medical Department reviews the most recent actual wound data in order to develop wound datasets for display on medical training devices (i.e., tethered and tetherless mannequins, moulage, and virtual trainers) and use in medical training scenarios. This will allow for training on the most recent and relevant wounds being experienced on the battlefield. This capability is extremely valuable to next deploying units.

3.2.6 (U) The MSTC Program took all this analysis into consideration and worked to develop a program that fills the identified training gaps with a lifecycle management approach to program management, utilizing a spiral acquisition strategy to system modernization and development. The MSTC Program provides a sustained, maintained, and supported Army training asset, providing a regional training capability, located at the installation level.

3.2.7 (U) Additional analyses using the Mission Essential Requirements (MER) Calculation Method was used to determine the number of exportable TC3 modules to be placed at the TSCs and then hand receipted to Soldier for training. This methodology and location of modules can be found at Enclosure 5 of the MSTC

Inc. 1, Rev. 1 Supporting documents.

3.3 (U) Supported ICDs and Related CDDs/CPDs/Joint DCRs

Capability

Requirement

CPD Contribution Related CDDs Related CPDs

Readiness

System Training

Medical System Training Center Program, Increment 1

Table 3.3 CPD Contributions

4 (U) Program Summary

4.1 (U) Program Strategy

The MSTC Program was initiated in response to a Vice Chief of Staff of the Army mandate and established sustainment and enhancement training of Soldier medics and CLS training to non-medical personnel to units that lacked medical personnel. This revision of the approved CPD addresses the need for the expansion of the MSTC program, improve medical task readiness and to provide a TC3X capability utilized to train

Soldiers on Warrior, individual, leader, and collective medical tasks of the Operational Force. Exportable

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modules, a total of 77, will be placed at the US Army TSCs worldwide for sub-hand receipt to Soldiers.

Combat medics will be trained on the use of the modules at the nearest MSTC.

4.2 (U) IOC and FOC Definitions for the current increment

4.2.1 Basis of Issue (BOI): Various Training Support Centers will be issued a certain number of TC3Xs.

The BOI was determined as shown in Enclosure 3 of the Supporting Documents.

4.2.2 (U) IOC Definition and target date. The MSTC Program reached IOC in 4QFY09. At that time 16

MSTCs were operational. The IOC for the TC3X program will be reached in 4QFY18 when 36 TC3X modules have been fielded.

4.2.3 (U) FOC Definition and target date. Presently there are 21 MSTCSs. The FOC will be attained in

4QFY24 when 25 MSTCs have been constructed. The remaining MSTC construction will be at Fort Bragg, NC in FY21 (second MSTC); Fort Hood, TX in FY22 (second MSTC); Camp Bullis, TX in FY23; and at

Camp Williams, UT in FY24. The FOC for the TC3X program will be reached in 4QFY20 when an additional 13 modules are fielded, for a total of 77 modules.

4.2.4 (U) Assets Required to Attain IOC and FOC

4.2.4.1 (U) Assets to attain IOC. The MSTC Program reached IOC in 4QFY09. At that time 16 MSTCs were operational. The IOC for the TC3X program will be reached in 4QFY18 when 36 TC3X modules have been fielded.

4.2.4.2 (U) Assets to attain FOC. The FOC for the MSTC program will be attained in 4QFY24. MSTCs will be constructed at Fort Bragg, NC in FY21 (second MSTC); Fort Hood, TX in FY22 (second MSTC); Camp

Bullis, TX in FY23; and at Camp Williams, UT in FY24. The FOC for the TC3X program will be reached in 4QFY20 when a total of 77 modules have been fielded per the distribution plan.

5 (U) Production KPPs, KSAs, and APAs

5.1 (U) Mandatory KPPs

5.1.1 (U) Force Protection

The Force Protection KPP is not required for this capability.

Justification: Section 141 of the National Defense Authorization Act for Fiscal year 2005 mandated a KPP for Force Protection for manned systems and any equipment intended to enhance personnel for health protection. This system does not directly impact Soldier force protection and therefore a Force Protection

KPP is not required.

5.1.2 (U) System Survivability

The System Survivability KPP is not required for this capability.

Justification: Section 141 of the National Defense Authorization Act for Fiscal year 2005 mandated a KPP for survivability for manned systems and any equipment intended to enhance personnel for survivability.

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This system does not directly impact Soldier survivability and therefore a System Survivability KPP is not required.

5.1.3 (U) Net-Ready

The Net-Ready KPP is not required for this capability.

Justification: This system does not require interface with any other system or capability making the Net-

Ready KPP not applicable.

5.1.4 (U) Sustainment

The Sustainment KPP is not required for this capability.

Justification: The MSTC Inc. 1, Rev. 1 is acquisition category (ACAT) III and not Joint Requirements

Oversight Council (JROC) Interest. The Sponsor has determined that the manufacturer's stated reliability is sufficient and does not need to be further defined.

5.1.5 (U) Energy

The Energy Efficiency KPP is not appropriate for this capability.

Justification: The MSTC Inc. 1, Rev. 1 CPD components shall be designed to current ENERGY STAR and industry compliance standards for energy efficiency.

5.2 (U) Additional KPPs, KSAs, or Attribute

5.2.1 (U) KPP #1 – System Training.

Each MSTC system must have the capability to train 2,500 personnel annually [T] = [O].

Rationale: Soldiers continue to die from three main causes: hemorrhage, airway compromise, and tension pneumothorax. The treatment provided in the first 10 minutes is the most critical to a casualty’s survival.

Lessons Learned has shown that in these critical 10 minutes it is the Soldier/first responder, not the Medic that, more often than not, is the first to provide life-saving care to the casualty. The MSTC provides critical battle-focused training to combat medics and combat lifesavers and sustains critical medical skills.

Moreover, MSTC training provides Commanders the greatest flexibility in creating training that is relevant to the current operational environment and the unit’s mission essential task list.

5.2.2 (U) KPP #2 – TC3X System Performance

The TC3X system mannequins will provide a modular and scalable medical training system for Soldiers which accurately replicates realistic medical conditions and injuries IAW historical battle injuries and documented within the Joint Trauma Registry [T] = [O]. TC3X will facilitate training Soldiers how to treat and manage trauma and polytrauma injuries. In order to accurately represent these injury types, the TC3X system should have animatronic-type movement of upper and lower limbs, provide realistic bleeding and fluid secretion, capable of simulating respiratory action, simulate physiological responses and accurately represent the human anatomy for all genders.

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Rationale: IAW DoDI 1322.24 dated October 6, 2011, “Medical readiness training programs shall include realistic individual and collective medical skills training and shall maximize the use of emerging technology, including distance learning, simulation and virtual reality.” The use of the TC3X system provides the commander the necessary tools and devices to meet the medical training requirements at the point of injury.

5.2.3 (U) KPP #3 – TC3X System Exportability

The TC3X system will be easily exportable by military and civilian vehicles and will weigh no more than

250 pounds [T] = [O] per each sub-component mannequin. To facilitate the exportability, the TC3X system should be ruggedized, water resistant, operate in extreme temperatures and be able to operate on battery power.

Rationale: In order for the TC3X system to be a truly exportable package that the commander can utilize to train Soldiers, the system must be easily transportable by organic unit equipment and personnel to and from a location of the commander’s choosing. The 250 pound threshold requirement is in line with one Soldier being able to fireman carry another Soldier that is within the 95th percentile of height and weight with a full combat load. This accommodates all Active and Reserve components and allows them to achieve their training objectives IAW DoDI 1322.24, TC 8-800, and AR 350-1.

5.2.4 (U) APA #1 – Simulation of Battlefield Conditions. Each MSTC and each TC3X module will simulate battlefield conditions 95% of the time [T] = [O].

Rationale: Each MSTC System provides a modifiable, reconfigurable, and sustainable capability to simulate contemporary and future operating environments (COE and FOE) with associated stressors of various combat conditions to include hostile and friendly force engagement, with diverse battlefield environments – to include exterior training lanes. Training platforms will train, test, and validate trainees’ abilities within the technical, applied, and tactical realms of combat medicine. The use of these simulated casualties, conditions, and environments for the applications of combat medicine under conditions that trainees could encounter on contemporary and future battlefields, before situations on the actual battlefield, is paramount in preparing Soldiers for battle. The current number of MSTCs does not have the throughput capacity to support the Operational Force training without an exportable capability. TC3X provides leaders with

TADSS to realistically integrate casualties into their training. TC3X has the capability to demonstrate the most common battlefield injuries challenging the non-medical Soldier to improve medical task readiness.

80% of battlefield casualties are initially treated by themselves or their buddy. Realism in casualty training increases Soldier confidence and provides Commanders with an ability to assess Soldier readiness. Most importantly commanders want exportable, realistic training at the place where Soldiers train. This training will result in the decrease of preventable deaths on the battlefield.

5.2.5 (U) APA #2 - Standardization. Each MSTC and each TC3X module will have standardized training

90% of the time [T], 95% of the time [O].

Rationale: An MSTC System is a standardized “suite” of supporting component systems with Virtual

Patient System (VPS), Instruction Support System (ISS), Medical Training Command and Control (MT-

C2), and the Medical Training Evaluation and Review System (MeTER). It maximizes the use of enabling technology and supporting training devices for both classroom and full tactical training capabilities such as

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connecting device controllers with training devices using Bluetooth. The systems do not require operating on the Department of Defense information network. They will provide a standardized design and training methodology, which maximizes a reconfigurable, modifiable, and sustainable training capability to fully meet COE and FOE training requirements. Medical training throughout the Force must be standardized (as per the original identified requirement) in capability, process, procedures, and standards, in common core

(i.e., base modules) of medical skill for the Force, with the added capacities (i.e., tailored modules) to meet the warfighter’s training requirements. MSTC Systems will ensure the quality of training technical, applied and tactical aspects of combat medicine is critical to defeating the enemy’s intention to kill or maim. The current number of MSTCs does not have the throughput capacity to support the Total Force training without an exportable capability. Training Support Centers are best suited to support the mobility of TC3X across installations to meet Commander training demands and the locations where they train their Soldiers and unit. Medical Non-commissioned Officers become a Commander’s primary trainer using the exportable capability kit. Commanders now have realistic casualty capability to train, evaluate and develop Soldier confidence and proficiency in the Individual Soldier Warrior Tasks. Leaders also can incorporate the training devices into collective and leader tasks. TC3X composition of multi-task (full body system replication), part task (key body areas) and moulage training devices along proponent provided training support package provide integrated capability to improve Soldier medical task readiness and reduce preventable deaths on the battlefield.

5.2.6 (U) APA # 3 – Training Strategy. Every MSTC must monitor, measure, record assess, and provide student feedback on student performance with 99% of the instruction [T] = [O]. Each TC3X module must measure and record personnel trained on individual, collective, or leader tasks with 90% utilization [T] =

[O].

Rationale: MSTC Systems are an Army training asset, with a regional training requirement, located at installations, delivering effective medical training with a standardized training platform for both classroom and simulated battlefield conditions, to better prepare Soldiers for the application of medical interventions under combat conditions. The MSTC Program has three priorities for providing combat medical training.

Priority I: next deploying units – those units which are preparing to deploy will trump or supersede all other scheduled or unscheduled training. Priority II: sustainment – sustainment of combat medical skills for medical and non-medical personnel in order to maintain medical skill certification. This priority takes precedence over Priority III training and is superseded by Priority I training requirements. Priority III: as available – training which meets additional training desired by using units, and is provided only when time and resources allow, and only after all Priority I and Priority II training is completed. Priority I and II training will supersede and displace all in-process, and scheduled and unscheduled Priority III training at all times. The mission of the MSTC Program is an Army program which supports medical training for both medical and non-medical personnel across the Operational Force. The MSTC program supports the Active, Reserve, and National Guard. Sustainment of medical certifications is second only to training required for next deploying units. Other training which support using units, and does not fall within the first two priorities can be conducted at MSTC sites; however, this training is the lowest priority and will not, under any circumstance, take precedence over them. The current number of MSTCs does not have the throughput capacity to support the Operational Force training without an exportable capability. TC3X allows

Commanders to train at the point of need, evaluate Individual Soldier Skills, and other essential collective tasks necessary to achieve unit Objective T. TSCs will capture utilization based on Soldiers trained and the type of tasks trained. TC3X has two priorities: Individual Soldier medical task including combat life saver training readiness for deploying and home station training. Second priority is unit or collective unit

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readiness leading to achieving Objective T requirements. TCS will provide operator maintenance while the

MSTC program will provide TADSS sustainment, warranty, and scheduled and unscheduled maintenance.

Units will be responsible for providing their own class VIII supplies to conduct training.

5.2.7 (U) APA #4 – Training Curriculum. The MSTC must train required Soldiers on the following tasks

100% of the time: TC8-800 (MEDIC), CLS, and Warrior Skills [T] = [O]. The TC3X must train Soldiers on the following tasks 90% of the time: Individual Soldier Warrior Tasks, Combat Lifesaver, combat medic train the trainer, unit collective medical tasks and leader tasks [T] = [O].

Rationale: The MSTC Program develops, fields, and sustains a standardized training platform for Combat

Medics, Combat Lifesavers, and Medic Train the Trainers through approved curriculums for training

Individual Soldier Warrior Tasks, TC 8-800 (MEDIC), and CLS POIs. AMEDDCS/Health Readiness

Center of Excellence approves or obtains TRADOC approval for training curriculums which the MSTC or

TC3X will support. The PEO STRI’s PM, MedSim develops, procures, fields, and sustains the training capability which supports medical task proficiency, confidence and readiness. The MSTC and now Combat

Medics use the approved curriculums to train the groups above. AMEDDCS/HRCoE provides fielded

MSTC sites their site certifications to train authorized POIs through the PM, MedSim. Training conducted using MSTC Systems, which is not within AMEDD authorized POIs, will not consume or utilize MSTC

Program resources or assets. The current number of MSTCs does not have the throughput capacity to support the Operational Force training without an exportable capability. An exportable capability provides leaders and their combat medics with TADSS to realistically train Individual Soldier Warrior Tasks and exercise a unit collective and leader tasks. Commanders do not have to use their resources to obtain training devices in order to achieve medical task readiness. Most importantly commanders want exportable, realistic training at the place where Soldiers train. This training will result in the decrease of preventable deaths on the battlefield.

5.3 (U) KPP/KSA/Other Attributes Rollup

Tier 1-3 JCAs

Key Performance Parameter Production Threshold Production Objective

1. Force Support

1.4. Health

Readiness

KPP #1 – System Training (U) The MSTC must have the capability to train 2,500 Soldiers annually.

(U) The MSTC must have the capability to train 2,500 Soldiers annually.

1. Force Support

1.4. Health

Readiness

KPP #2 – TC3X System Performance

(U) The TC3X system mannequins will provide a modular and scalable medical training system for Soldiers which accurately replicates realistic medical conditions and injuries IAW historical battle injuries and documented within the Joint Trauma Registry. TC3X will facilitate training Soldiers how to treat and manage trauma and polytrauma injuries. In order to accurately represent these injury types, the TC3X system should have animatronic-type movement of upper and lower limbs, provide realistic bleeding and fluid secretion, capable of simulating respiratory action, simulate physiological

(U) The TC3X system mannequins will provide a modular and scalable medical training system for Soldiers which accurately replicates realistic medical conditions and injuries IAW historical battle injuries and documented within the Joint Trauma Registry. TC3X will facilitate training Soldiers how to treat and manage trauma and polytrauma injuries. In order to accurately represent these injury types, the TC3X system should have animatronic-type movement of upper and lower limbs, provide realistic bleeding and fluid secretion, capable of simulating respiratory action, simulate physiological

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UNCLASSIFIED

Tier 1-3 JCAs

Key Performance Parameter Production Threshold Production Objective responses and accurately represent the human anatomy for all genders.

responses and accurately represent the human anatomy for all genders.

1. Force Support

1.4. Health

Readiness

KPP #3 – TC3X System Exportability

(U) The TC3X system will be easily exportable by military and civilian vehicles and will weigh no more than 250 pounds per each sub-component mannequin. To facilitate the exportability, the TC3X system should be ruggedized, water resistant, operate in extreme temperatures and be able to operate on battery power.

(U) The TC3X system will be easily exportable by military and civilian vehicles and will weigh no more than 250 pounds per each sub-component mannequin. To facilitate the exportability, the TC3X system should be ruggedized, water resistant, operate in extreme temperatures and be able to operate on battery power.

Tier 1-3 JCAs Additional Performance

Attribute Production Threshold Production Objective

1. Force Support

1.4. Health

Readiness

APA 1 – Simulation of battlefield conditions

(U) Simulation of battlefield conditions will be the focus of medical training 95% of the time. The MSTC Program will provide commanders with an exportable capability to train Soldiers on realistic casualty Warrior skills training at the individual, leader, and collective level to 60% of the Total Force.

(U) Simulation of battlefield conditions will be the focus of medical training 95% of the time. The MSTC Program will provide commanders with an exportable capability to train Soldiers on realistic casualty Warrior skills training at the individual, leader, and collective level to 70% of the Total Force.

1. Force Support

1.4. Health

Readiness

APA 2 – Standardization (U) Standardization will be present in all MSTCs 90% of the time. The MSTC Program will provide commanders with an exportable capability to train Soldiers on realistic casualty Warrior skills training at the individual, leader, and collective level to 60% of the Total Force.

(U) Standardization will be present in all MSTCs 95% of the time. The MSTC Program will provide commanders with an exportable capability to train Soldiers on realistic casualty Warrior skills training at the individual, leader, and collective level to 70% of the Total Force.

1. Force Support

1.4. Health

Readiness

APA 3 – Training Strategy (U) MSTCs must monitor, measure, record, assess, and provide student feedback on student performance with 99% of instruction.

Each TC3X module must measure and record personnel trained on individual, collective, or leader tasks with 90% utilization.

(U) MSTCs must monitor, measure, record, assess, and provide student feedback on student performance with 99% of instruction.

Each TC3X module must measure and record personnel trained on individual, collective, or leader tasks with 90% utilization.

1. Force Support

1.4. Health

Readiness

APA 4 – Training Curriculum

(U) MSTCs must train required Soldiers on the following medical tasks 100% of the time:

TC 8-800 (MEDIC)

TC3

CLS

Soldier Warrior Skills The TC3X must train Soldiers on the following tasks 90% of the time:

Individual Soldier Warrior Tasks, Combat Lifesaver, combat medic train the trainer, unit collective medical tasks and leader tasks.

(U) MSTCs must train required Soldiers on the following medical tasks 100% of the time:

TC 8-800 (MEDIC)

TC3

CLS

Soldier Warrior Skills The TC3X must train Soldiers on the following tasks 90% of the time:

Individual Soldier Warrior Tasks, Combat Lifesaver, combat medic train the trainer, unit collective medical tasks and leader tasks

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UNCLASSIFIED

Tier 1-3 JCAs Additional Performance Attribute

Production Threshold Production Objective

6 (U) Other System Attributes

6.1 (U) Embedded Instrumentation, EA and WARM requirements

This capability does not require Built-In Test or Built-In Test Equipment (BIT/BITE). Furthermore, the

MSTC does not require Electronic Attack (EA) or wartime Reserve Modes (WARM). The MSTC is not considered mission critical and does not require protection from the effects of electromagnetic radiation.

6.2 (U) Human System Integration

6.2.1 (U) Manpower - Introduction of the MSTC capability shall not increase the overall number of personnel, either, military or civilian, required to operate, maintain, and support the item.

6.2.2 (U) Personnel - The operation, maintenance, and support of the MSTC capability shall not require aptitudes, skills, or capabilities beyond those currently present in the user population.

6.2.3 (U) Training - The instruction and resources required providing the Soldier and maintainer with knowledge, skills and abilities in proper operation, maintain, and support Army systems shall not significantly increase due to the introduction of the MSTC capability.

6.2.4 (U) Human Factors Engineering - The MSTC capability design shall promote effective Soldier-machine integration for optimal total system performance. Design principles taking into account human capabilities and limitations shall be incorporated into system definition, design, development, and evaluation. This includes concepts of human-computer interface (e.g., ease of perception and comprehension of displays, ease of use of controls) and compatibility of the MSTC capability with other mission-essential equipment (including but not limited to use with standard combat gear; CBRN, and environmental clothing). The MSTC capability should not interfere with the performance of common

Soldier tasks. Equipment design must consider mission-dependent tasks and demands through consultation with subject matter experts, in order to maximize ease of use, minimize workload and enhance mission performance.

6.2.5 (U) System Safety - Safety, health, environmental, fire, software controlled hazards, and ergonomic hazards associated with the use, maintenance, transportation, storage, handling, and demilitarization of the

MSTC will be identified, evaluated/assessed, and mitigated or controlled to an acceptable level. The resolution of all hazards will be formally documented through a hazard tracking system and the risk associated with the residual hazard, will be accepted by the designated approving authority IAW AR 385-10

Army Safety Program and Department of the Army (DA) Pamphlet (Pam) 385-16 System Safety

Management Guide and will be in accordance with MIL-STD-1472G Human Engineering. A Safety

Assessment Report (SAR) will be completed as part of the design process to ensure the MSTC is free from conditions, which can cause death, injury, or illness to the operator, maintainer, trainer, or handler. To ensure that safety hazards are eliminated or reduced to an acceptable level, programs, developing solutions to this CPD, must establish a System Safety Program (SSP), in accordance with MIL-STD-882D DOD

Standard Practice for System Safety.

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6.2.6 (U) Health Hazards - The MSTC will comply with the DOD Instruction (DODI) 6055.1 requirement of ensuring all new and modernized systems meet applicable safety and health standards. The Army Health

Hazard Assessment (HHA) Program assists the acquisition program in ensuring the program meets DODI

5000.02, MIL-STD 882D, and AR 40-10 health risk management requirements to identify, evaluate, and make recommendations to eliminate and/or control health hazards associated with the life-cycle management of material systems. An HHA Report will be completed early in the system’s life-cycle in order to influence early design changes. Updates to the HHA may be required as the system proceeds through the acquisition process and may be subject to data availability. Modifications or changes to the system or user scenario any time during the acquisition life cycle of the system may result in the need for an updated HHA Report. An HHA is provided by the U.S. Army Public Health Center (APHC) IAW AR 40-

10, Health Hazard Assessment Program in Support of Army Materiel Acquisition Decision process.

Information from these HHA Reports will serve as input to safety and health tracking documents, Manpower and Personnel Integration Assessments, and Programmatic Environment, Safety, and

Occupational Health Evaluations. Specific potential health hazards associated with the MSTC that shall be eliminated or controlled include; acoustic energy (steady-state) IAM DA PAM 40-501 and MIL-STD 147E, biological substances (i.e., pathogenic microorganisms and sanitation issues (IAW AR 40-5, oxygen deficiency (i.e., inadequate ventilation), IAW OSHA 29 CFR and MIL-STD 1472G, radiation energy (i.e., ionizing, nonionizing, and directed energy) IAW AR 40-5, temperature extremes (i.e., heat and cold injury)

IAW MIL-STD 1472G, trauma (i.e., blunt, sharp, or musculoskeletal) IAW MIL-STD 1472G, ultrasound

(i.e., industrial and medical ultrasound exclusive of auditory effects) IAW DA PAM 40-501, and chemical substances IAW OSHA Permissible Exposure Limits and the American Conference of Governmental

Industrial Hygienists Threshold Limit Values. Chemical substances can include engine combustion products and operation and maintenance chemicals.

6.3 (U) Natural Environmental Factors

The MSTC has defined storage ranges in regards to temperature. Extreme meteorological and oceanographic (METOC) conditions which threaten the shipping, storage, or administration of the MSTC will be forecast by a Joint or Service METOC activity and provided via an appropriate command and control system.

6.4 (U) Physical and Operational Security

This capability does not require physical and operational security beyond that of typical requirements for storage and transport of other medical devices.

6.4.1 (U) Facilities will require a climate controlled and covered storage unit to prevent extreme hot and cold temperatures and wet environments from damaging the equipment. The facility will need a loading dock or loading door to accommodate 48”x68”x57”. The storage will be 152 foot cubed. A fork lift w/ dock or Pallet Jack w/o dock will be required. Security for the TC3X will be as delineated in AR 190-51, Security of Unclassified Army Property (Sensitive and Nonsensitive).

6.5 (U) Weather, Oceanographic, and Astrophysical Support

Extreme METOC conditions which threaten the shipping, storage, or administration of the MSTC will be forecast by a Joint or Service METOC activity and provided via an appropriate command and control system.

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UNCLASSIFIED

6.6 (U) Transportability and deployability considerations

The MSTC will not be transportable by land, sea, and air; however, the TC3X will be transportable by land, sea, and air. The TC3X's dimensions are 152 feet cubed (48’’x68”x57”) and weigh approximately 3000lbs.

The TC3X will be packaged on two pallets. The first pallet will consist of six pieces and weigh approximately 870lbs. The second pallet will consist of four pieces and weigh approximately 620lbs. The

TC3X will require a large vehicle such as a Two Ton or Light, Medium, Tactical Vehicle (LMTV) to transport the package. The transit cases require minimum two man lift or one man transport with wheels.

This product should not require storage conditions outside those currently available. Transportability is not an issue beyond the current logistics system.

6.7 (U) SWaP-C margin requirements/open systems attributes

This capability does not have space, weight, and power cooling (SWaP-C) or open systems attribute requirements associated with it.

7 (U) Spectrum Requirements

7.1 (U) Electromagnetic Environmental Effects (E3) Summary

The Contractor shall determine the criteria and verification method to ensure that the system's electronic or electrical hardware configuration is not a source of electromagnetic interference (EMI) or a victim of E3 in the intended operational environment in which it is installed or at its operational locations. The Contractor shall establish and maintain a process to verify and assure that the system operations functionality is not affected by E3.

7.2 (U) Spectrum Summary

This capability does not receive or transmit information via radio transmitters.

8 (U) Intelligence Supportability

As per Chairman of the Joint Chiefs of Staff Instruction (CJCSI) 3312.01B, all requirement categories were considered. However, there are no intelligence requirements that would be levied against the intelligence community for the fielding of the MSTC capability.

9 (U) Weapon Safety Assurances

The MSTC is not a weapons system and weapon safety assurance is not applicable.

10 (U) Technology Readiness

10.1 (U) Technology Challenges

No problems are anticipated.

10.2 (U) Technology Readiness Assessment

Currently no technologies with the MSTC System are expected to create manufacturing readiness issues. No sub-system components are required in large quantities, and although new technology development is required, no components utilize dramatically unchartered or unexplored technologies which are unsupported from current technology industries.