Q&A: Major General Russell J. Czerw
Written by Christian Sheehy
EDUCATION MODERNIZER:
Envisioning, Designing and Training a
Premier Military Medical Force
Major General Russell J. Czerw
Commander
Army Medical Department Center and Schools
Fort Sam Houston, Texas
Major General Russell J. Czerw became the commander, U.S. Army Medical Department Center and School and Fort Sam Houston on 11 July 2006. He became the Chief of the Army Dental Corps on 10 July 2006.
Czerw was born and raised in Utica, N.Y. He received his Bachelor of Science degree in 1983 from Saint Lawrence University in Canton, New York where he was also a Distinguished Military Graduate from the school’s ROTC program. He received his dental degree from the State University of New York at Buffalo Dental School in 1987.
After graduating from dental school, he attended the Advanced Education in General Dentistry-One Year Program at Fort Jackson, S.C. He then went to Pirmasens, Germany, before taking over as the OIC of 1st Platoon, 124th Medical Detachment (DS) and the Muenchweiler Dental Clinic. After graduating from the two-year General Dentistry Residency Program at Fort Hood, Texas, he served as the Dental Corps’ Professional Development Officer in Alexandria, Va . He went on to command the 464th Medical Company (DS) in Landstuhl, Germany and then became the Chief of the Dental Corps Branch, PERSCOM, in Alexandria, VA.
Czerw commanded the 93rd Medical Battalion (DS) in Heidelberg, Germany after graduating from the Army War College in Carlisle, Pa in 2002. During his tour, Czerw deployed to Poland as the Task Force Medical commander for Victory Strike III and to Iraq for Operations Enduring and Iraqi Freedom where he was a Task Force commander for dental, preventive medicine, veterinary and combat stress control units. His last assignment was commander, U.S. Army Dental Command, Fort Sam Houston, Texas.
Czerw has completed numerous military and training schools. He wears the Expert Field Medical Badge and the German Abzeichen fur Leistungen (sports badge) in Gold. His awards and decorations include the Legion of Merit, Bronze Star, Meritorious Service Medals (4OLC), Army Commendation Medal (1OLC), Army Achievement Medal (2OLC), Meritorious Unit Citation, Army Superior Unit Award, National Defense Service Medal (Bronze Star), Armed Forces Expeditionary Medal, Iraqi Campaign Medal, GWOT Service Medal, Armed Forces Service Medal, Military Outstanding Voluntary Service Medal, NATO Medal and the Order of Military Medical Merit. He is a graduate of the Officers Advanced Course, the Army Command and General Staff College and the Army War College.
Czerw has a Doctor of Dental Surgery Degree and a Masters Degree in Strategic Studies. He holds the Surgeon General’s “A” Proficiency Designator and is a Diplomate of the Federal Services Board of General Dentistry and the American Board of General Dentistry. He is a Master in the Academy of General Dentistry, and is a member of various professional organizations. Czerw has published numerous professional articles and has presented several lectures on dental and military subjects.
Major General Czerw was interviewed by MAE editor Christian Sheehy.
Q: Sir, I’d like to start by asking you to give us a brief history of the AMEDDC&S and its mission.
A: Our mission is: We envision, design, and train a premier military medical force for full spectrum operations in support of our nation. Our vision is: To be the foundation on which the Army Medical Department [AMEDD] is built, sustained, and transformed. The history of the United States Army Medical Department Center and School can be traced back to the Medical Field Service School under the command of Colonel Percy M. Ashburn, Medical Corps, which was activated at Carlisle Barracks, Pennsylvania, on 1 September 1920. The establishment of the school was prompted by a request from the surgeon general, Merritt W. Ireland based on the lessons learned in preparing officers of the Medical Department to serve in World War One. The Medical Department established three large training camps to provide limited training for the officers of the Medical, Dental, and Veterinary Corps and enlisted personnel. The school was re-located to Fort Sam Houston, Texas in 1947.
The school continued its normal mission until 27 June 1950, when the United States entered into the Korean Conflict and a partial mobilization began for the Armed Forces. By September, the student population increased significantly and intensive training was implemented to meet the demands for medical personnel on and off the battlefield that continued throughout the duration of the conflict. The Medical Field Service School successfully accomplished its wartime mission and by 1953, the school returned to its normal level of training. In 1957, the senior leadership of the Army Medical Department felt the name “Medical Field Service School” did not clearly express its mission and on 1 October 1957, the school was redesignated the Army Medical Service School. This change would only exist for a few years and on 1 January 1961, the school was again designated the Medical Field Service School.
The Medical Field Service School again met the needs for medical support in the Vietnam War and was awarded the Distinguished United States Army Service School Award which recognized the school for its outstanding achievements and service since it was established.
The Army Medical Department was reorganized in 1972 and on 10 December 1972, the Medical Field Service School was re-designated the Academy of Health Sciences, and made responsible for all health care education. In 1973, the functions of the U.S. Army Veterinary School, the U.S. Army Walter Reed Army Institute of Nursing, the U.S. Army Medical Equipment and Optical School, the U.S. Army Combat Developments Command Medical Service Agency, and the U.S. Army Medical Training Center were transferred to the Academy of Health Sciences.
This major reorganization established the school as one of the largest military medical training institutions in the world. In 1975, the Academy of Health Sciences was assigned as a major subordinate unit of the U.S. Army Health Services Command.
The primary mission of the Medical Field Service School in 1920, and its evolution into the Army Medical Department Center and School today remains unchanged. Although the mission has been greatly expanded, it is still focused on producing the most professional, competent and dedicated soldier medics on and off the battlefield.
Q:. What are some of the challenges for the military medical personnel as far as keeping up with skills and incorporating lessons learned?
A: The entire field of medicine is a dynamic environment with a constant influx of new pharmaceuticals, continuously evolving treatment protocols, and the emergence of new educational and treatment technologies. Our civilian peers are challenged every day with keeping up to date in this environment. Our providers have the additional challenges of learning how to best deliver care not only in the traditional, civilian care environments but also on the battlefields that are among the most lethal in the history of combat. Our highly trained personnel need to constantly evolve their treatment protocols as the injury patterns on the battlefield evolve. We have the lowest died of wounds rate in our history despite the horrific injury patterns suffered by our military personnel. It is critical that we continue to capture our clinical observations, insights, and lessons learned at the point of injury and throughout the entire medical evacuation chain while not losing focus on the patient in front of us needing our complete attention. We work diligently to incorporate lessons learned into our pre-deployment training. This is just in time training we provide to our healthcare professionals and para-professionals right before they deploy to the combat zone. Part of the challenges we face involve breaking our healthcare professionals away from their daily care delivery mission to attend this critical, pre-deployment training.
Q: How do distance education initiatives help in meeting those requirements along with advancing educational goals among the servicemembers?
A: Distance education is an older term which emphasizes the place of learning. A more modern term is distributed Learning [dL] which emphasizes the pedagogical approach, in which students learn in an interactive and collaborative environment at their own pace independent of place and time. Instructional approaches may include simulations, gaming, video, role playing, interactive multimedia, and interactive video decision making.
Along with new pedagogical approaches, distributed learning provides technological solutions and aids to increase the availability of the training, for example through the use of computers, iPods, and video tele-training. Distributed learning methods can provide a customized learning presentation, in which learners set the pace and select learning content to best meet their needs. This may increase learning effectiveness as well as efficiency.
Distributed learning presentations may be combined with traditional classroom approaches in a blended learning solution—with some course content covered individually, at the learner’s own pace, in combination with instructor-led presentations in which the learner can ask questions of a live, expert instructor.
Interactive multimedia [IMI] — Web-based or DVD — provides individualized instruction anytime and any place. IMI courseware may be taken as a prerequisite to resident courses, in combination with resident courses as blended learning, or as a follow-up to resident courses as sustainment training. Video tele-training allows instructor-led classes to be transmitted to soldiers in distant locations. The training sessions also can be recorded and replayed on demand at later times. TRADOC is implementing mobile selfcontained dL classrooms which can be dropped into any theater worldwide to further enhance the use of distributed Learning.
All these methods are in use across AMEDD and around the world to meet soldiers’ training needs — video- tele-training, interactive multimedia, blended learning, and resident training.
Q: What are some of the current and future trends in military education that are and will be areas of emphasis in the future and that can be serviced by distance learning?
A: Distributed learning can and will be used in virtually all facets of military medical education. An area of particular emphasis in the near future is the proliferation of blended learning concepts which will soon be piloted at the AMEDDC&S.
The current educational model that requires cohorts of soldiers to go through the didactic learning process together is often rate limited by the ability of the group to absorb information. Blended learning is an educational process in which those portions of instruction that can be effectively done via distributed learning are delivered in that manner to the students, each at their own pace. This means some students will finish before others, but rather than wait on their cohort, they proceed to the next phase of instruction. Blended learning has the potential to increase the efficiency of education tremendously by allowing educational staff to focus their efforts on those individuals that need the most assistance. From the military corporate perspective, it means proficient soldiers ready for duty sooner.
The use of distributed learning to maintain proficiency in the force is another area that is expanding by leaps and bounds. The use of distributed learning courses for this purpose has already had an impact on the amount of travel Soldiers need to do in order to attend proficiency courses, and this effect will continue to expand.
Distributed learning is the fastest and most effective method available for getting rapidly evolving training requirements out to the force. Case in point was training for the staff of the recently created Warrior In Transition Units [WTU], designed to deal with wounded soldiers returning from combat. There was no precedent for this type of unit, and 35 of them were stood up simultaneously across the Army with personnel that were for the most part unfamiliar with Army Medicine and the wounded warrior mission. Training for these new personnel was created and executed worldwide in a matter of four months via distributed learning. Before the advent and proliferation of automation technology, this process would have taken upwards of a year if not more. This same approach has been used to distribute traumatic brain injury training, detainee healthcare operations training, suicide awareness training and many other training initiatives that required rapid and broad dissemination.
Q: What are some of the organizations you are partnering with in distance learning initiatives?
A: We are partnering with the Navy and Air Force on a number of training initiatives. We expect those partnerships to expand over time. We are also working with the Joint Medical Executive Skills Institute [JMESI]. JMESI is a Department of Defense Executive Agency deeply involved in the training of healthcare leaders. JMESI already has a robust, online training catalogue focused on the 39 key competencies needed for the successful leadership and management of military, healthcare organizations. Many of their resident courses incorporate blended learning. We are also looking at partnering opportunities with the Department of Veterans Affairs. The Academy of Health Sciences recently stood up a Center for distributed Learning charged with developing distributive learning products as well as overseeing dL for the entire Army Medical Department. The number of dL partnerships will continue to grow as we seek to maximize learning while managing cost. Please note that Center for distributed Learning is not a typo. We are using the lower case to be consistent with our abbreviation, “dL” used when referring to this organization.
Q: Where do you see the greatest need for distance education in the future?
A: Distributed learning already is being extensively used with sustainment training and Phase 1 pre-requisite training to resident courses and with the National Guard and Reserve components. The future will see increased use of dL in blended training approaches in resident courses and greater use of mobile training solutions such as the dL mobile classrooms and individual use of iPods. DL and mobile learning solutions will bring us closer to “anytime, anywhere training.” There will be greater use of highly interactive approaches including gaming, simulations, role playing, and interactive video decision making training.
Q: Sir, what else would you like to add?
A: We are in the middle of one of the most complex consolidations in the history of the Department of Defense. The most recent Base Realignment and Closure Act mandated that we collocate and consolidate, where possible, the training of our enlisted medical personnel from across the three services. This mandate will lead to the establishment of the Medical Education and Training Campus [METC] at Fort Sam Houston. By allowing us to train together, the METC will help us ensure greater interoperability, the ability to have members from the various Services working effectively in the same unit or treatment facility. We will still retain service-unique training, training critical to ensuring our ability to perform our service-unique missions.
As part of the METC consolidation we are looking at expanding the use of blended learning, maximizing the use of simulation technology to include online games and incorporate non-traditional learning platforms, e.g. iPods. These are just some of the means for ensuring our training takes into account the learning preferences of our current generation of students. As you know, this new generation, the Millennials, were raised with technology that allows them on-demand access. ♦