Train like you Fight. Fight like you Train: Military Training Tactics Applied to Healthcare

With interlinked arms, we sat in the breaking surf of the Pacific Ocean on a frigid December morning. It was day one of an intense military training program. As I sat there exhausted, with my fellow trainees, on the brink of hypothermia and complete mental exhaustion, our even-keeled instructor, stood waist-deep in the surf with us providing guidance on the whys, whats, hows, and whens we’d be challenged with during our training.

Our instructor-led from the front – whatever we did, he did along with us, demonstrating a cool, confident “come follow me” attitude that we’d all come to adopt. Whenever his trainees were in the freezing Pacific surf, so was he. Whenver his trainees were running eight miles in soft sand and boots, so was he. This was the educational beginning and exposure to the most effective training methodology and tactics humanly known. An approach that is constantly bound with success and keeps our Nation’s finest prepared.


Now, as the Vice President of Consulting Services at Divurgent, I ensure our training methodology, applied across every aspect of delivery, is people and organization-centric, with a foundation of military tactics and clinical education (oh…I’m also a BSN) to successfully achieve maximum adoption in a time and budget-restrictive environment.

How do you achieve cost efficiency and new-process adoption in a fast-paced, dynamic, and high-stress environment? Through four very important nontraditional steps:

  1. Role Modeling.
  2. Unlearn.
  3. Habituation.
  4. Train like you Fight. Fight like you Train.

Role modeling – Credibility and respect in the military is earned by experience – being there, doing that. The same is true in healthcare. Effectively educating a Physician, Nurse, Pharmacist, Business Manager, and all other entities within a healthcare organization requires the same understanding and respect to effectively achieve adoption.

To answer this, Divurgent deploys customized Peer-to-Peer Modeling.

What does that mean? As a nurse, I want to learn my new system from a nurse, and not just any nurse, but an ED nurse like me who understands my legacy system, current workflows, future workflows, new system, and, most importantly, fits my organizational culture. Putting culture and mirrored experience first is the most overlooked factor in adoption – we recognize and mitigate that mistake.

Unlearn – Unlearning in an environment isn’t about forgetting – it’s about making a decision to execute an alternative learning and execution model to improve the organization. After the terrorist attacks on September, 11, the military was forced to make drastic operational changes – military units across the world had to make sudden, radical change to their proceses – unlearn what they’ve done. Healthcare is challenged with the same dramatic changes with new systems, technologies, and workflows.

To address this, Divurgent implements Reverse Super User Programs.

Divurgent training methodology focuses on change techniques to ensure unlearning occurs, such as Reverse Super User Programs, where the Super User with institutional credibility drives the class and the consultant trainer provides the “back of the room” and functionality support. The opposite in what we’ve experienced thus far, however, allows the key stakeholder let go of legacy and assume ownership of the new technology, process, resource, and/or policy.

Habituation – “It’s mind over matter gents. If you don’t mind it won’t matter,” our instructor said at the hight of one of my more miserable moments that December. He was deploying the technique of habituation. A psychological learning process wherein there is a decrease in response to a stimulus after being repeatedly exposed to it. In other words, the more you’re exposed to the change that you fear, the level of fear will decrease and eventually you just get used to it. As you’re probably starting to guess..learning in healthcare is no different.

For years, the industry focused on providing end user training 6-8 weeks prior to go-live. Leading software vendors and management consulting firms have not only agreed, but insisted upon this methodology. You’ve probably heard of it…it’s called “Just in Time Training.” Frankly, I call it “Cramming.”

Divurgent understands that training in a habitual manner means an early start…not “just in time.”

Training starts on Day One. Change management, organizational readiness, all these buzz words tie into the ability to prepare an organization to successfully navigate transformation. What we’ve learned is that implementing training and education tactics from the start of an implementation, throughout the lifecycle of an implementation, and long after a go-live are the keys to system adoption, not just activation. Some success factors include:

  • Involving the users in decision making
  • Leading lunch and learns
  • Assisting in the development of training materials
  • Letting Super Users lead training
  • Incorporating “Sneak & Peeks,” debate sessions, impact/workflow analysis, and walkthroughs
  • Communication…early and frequently
  • Identifying & delivering training through appropriate modalities

Over the course of the implementation leveraging Divurgent’s methodology your “Just in Time Training” will become “Review and Excitement Sessions.” Adoption rises, patient safety increases, fear decreases, and activation costs plummet.

Train like you Fight. Fight like you Train – In any military setting, the true effective learning was done in the field, complimented by some quick in-classroom debriefs. As both a soldier and nursing student, I needed to see and feel the change on the ground or on the floor. It helped me prioritize and be efficient in my workflow, keeping myself attentive to patient safety and centric to importance.

Simulation has long been the driver and secret of successful military training and what Divurgent uses with it’s healthcare clients.

Placing a clinician solely in a classroom elimiates the opportunity for them to hit the ground running. Imagine having an end user class, drop-in, simulation, or eLearinng session titled “risk and mitigation,” meaning what could potentially go wrong at go-live and how will you respond as an end user keeping the ORs at full case loads, ED flowing and billing on point? Train like you fight. Fight like you train.

Training and learning in Healthcare transformations have long been pedestrian. Our methodology is proven to shed activation costs, improve adoption, prepare optimization mindset, and protect your patients. Whether it is the beginning of a process, technology, resource, policy change, and/or simply looking to revitalize your current training program, it’s never too late to initiate a change in methodology.

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