{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T15:27:24Z","timestamp":1792510044844,"version":"4.5.0"},"reference-count":22,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Battlefield trauma remains a leading cause of preventable death, with hemorrhage and tension pneumothorax accounting for the majority of potentially survivable fatalities. A telemedicine-enabled workflow, in which combat medics acquire Extended Focused Assessment with Sonography for Trauma (E-FAST) images for transmission to a remote physician, represents a pragmatic solution to the diagnostic gap at the point of injury. The operational viability of this model depends critically on whether non-physician medics can reliably acquire interpretable images following brief, focused training. We hypothesized that a structured 4-hour training program would enable ultrasound-na\u00efve combat medics to achieve a telemedicine-ready image acquisition rate of \u226580% across all 6 standard E-FAST windows.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>This prospective, single-center pilot educational intervention enrolled 20 FAST-na\u00efve male combat medics (mean age 29.2\u2009\u00b1\u20092.4 years). The single-day intervention, structured according to the TIDieR framework, comprised a 4-hour didactic session followed by individualized hands-on practice to competency. The curriculum targeted standardized image acquisition rather than independent interpretation, minimizing cognitive load by decoupling psychomotor acquisition from diagnostic reasoning. Performance was assessed immediately post-training (T1) and at 4 weeks (T2). Each participant independently acquired 6 standard E-FAST windows on healthy volunteer models. Two independent, blinded emergency physicians rated each window using a validated 15-point rubric (3 domains on a 1-5 Likert scale, adapted from the QUICk framework). The primary outcome was the window-level rate of telemedicine-ready acquisition, defined a priori as both raters assigning \u226512\/15 to a given window. Between time point comparisons accounted for within-subject clustering using Generalized Estimating Equations (GEE). Interrater reliability was assessed using ICC (2,1).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The overall telemedicine-ready acquisition rate was 83.3% (100\/120 windows; 95% CI, 75.7%-88.9%) at T1 and 85.8% (103\/120; 95% CI, 78.5%-91.0%) at T2, meeting the a priori \u226580% hypothesis threshold at both time points. Competency was highest for the pelvic\/bladder (100%) and right upper quadrant (95%) windows at both assessments. The left upper quadrant window was most challenging (50% at T1; 60% at T2). At the participant level, 9\/20 (45%) achieved telemedicine-ready acquisition in all 6 windows at T2, and 15\/20 (75%) in at least 5 of 6. GEE modeling confirmed no significant change in acquisition probability between time points (adjusted OR 1.18; 95% CI, 0.82-1.70; P\u2009=\u2009.384). Total rubric scores were stable (P\u2009=\u2009.312). Median examination time decreased significantly from 108.5 s (IQR 88.0-139.0) to 104.0 s (IQR 86.5-131.0) at T2 (Wilcoxon signed-rank test: P\u2009=\u2009.003; effect size r\u2009=\u20090.47). Interrater reliability was good to excellent across all windows (ICC range: 0.854-0.976).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This preliminary, single-day, acquisition-focused training program enabled ultrasound-na\u00efve combat medics to acquire E-FAST images of sufficient quality for remote expert interpretation, with short-term retention demonstrated at 4 weeks. These findings provide proof of concept support for the image acquisition component of a telemedicine-based battlefield trauma assessment system. Future research should evaluate the complete telemedicine workflow, including image transmission under tactical field conditions, remote interpretation accuracy, and the impact on clinical decision-making and patient outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/milmed\/usag314","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:44:00Z","timestamp":1783471440000},"source":"Crossref","is-referenced-by-count":1,"title":["Feasibility of a Condensed Training Program Enabling Combat Medics to Acquire Telemedicine-Ready E-FAST Images: A Prospective Pilot Educational Intervention"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5907-9161","authenticated-orcid":false,"given":"Mehmet","family":"Tatl\u0131","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, University of Health Sciences, Van Training and Research Hospital , Van, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9653-3236","authenticated-orcid":false,"given":"Ertu\u011f","family":"G\u00fcnsoy","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University of Health Sciences, Van Training and Research Hospital , Van, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4279-297X","authenticated-orcid":false,"given":"\u00d6merul Faruk","family":"Ayd\u0131n","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Istanbul Yeni Y\u00fczy\u0131l University , \u0130stanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6472-5092","authenticated-orcid":false,"given":"Mehmet Necmeddin","family":"Suta\u015f\u0131r","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University of Health Sciences, Ba\u015fak\u015fehir \u00c7am and Sakura City Hospital , \u0130stanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,7,8]]},"reference":[{"key":"2026070720435811500_usag314-B1","doi-asserted-by":"publisher","first-page":"S431","DOI":"10.1097\/TA.0b013e3182755dcc","article-title":"Death on the battlefield (2001\u20132011): implications for the future of combat casualty","volume":"73","author":"Eastridge","year":"2012","journal-title":"care. 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