Cover: Educating and Training the Department of Defense Workforce for Global Health Engagement to Support the Geographic Combatant Commands

Educating and Training the Department of Defense Workforce for Global Health Engagement to Support the Geographic Combatant Commands

Published Jul 11, 2023

by Jefferson P. Marquis, Trupti Brahmbhatt, Aaron Clark-Ginsberg, Victoria M. Smith, David E. Thaler

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Research Questions

  1. Which DoD populations need GHE competencies (i.e., knowledge, skills, and abilities), and why?
  2. Which institutions are or could be responsible for GHE E&T for DoD populations?
  3. What curricula — programs, courses, and certifications — could these institutions offer?
  4. What instructional strategies are being employed for GHE E&T by these institutions? Are they appropriate for target populations?
  5. What are the challenges to providing GHE E&T, and how might they be overcome or mitigated?
  6. How should the components of GHE E&T be conceptually integrated? How might any changes necessary for GHE E&T improvement be strategically assigned and sequenced?

The importance of global health to U.S. national security was brought into sharp relief when the coronavirus disease 2019 (COVID-19) pandemic expanded exponentially in 2020 and inflicted serious and prolonged harm to the world's populations, economies, and political systems. For many national security experts, this recognition of global health's importance coincided with a belief in the value of U.S. Department of Defense (DoD) global health engagement (GHE), which encompasses a range of sometimes overlapping activities in the areas of force protection; humanitarian assistance and foreign disaster relief; nuclear, chemical, and biological defense; and building partner capacity and interoperability. However, DoD is constrained in its ability to conduct GHE activities by limitations in the way the department, as a whole, organizes, manages, and resources GHE activities and develops its workforce for GHE.

Using a systematic review of the GHE literature, discussions with more than 80 subject-matter experts and officials, a review of materials from nearly 70 GHE-relevant blocks of instruction, and two GHE stakeholder workshops, the authors developed key findings and policy recommendations with respect to target student populations, GHE competencies, professional development pathways, GHE courses and course providers, and instructional strategies. In addition, they developed a concept for integrating the major GHE education and training (E&T) components and a prioritized framework for implementing the policy recommendations. This report should be of interest to members of DoD's GHE community, as well as officials and policy analysts in the larger DoD medical/health and security cooperation communities.

Key Findings

A large portion of the DoD medical/health community who may become engaged in GHE activities do not receive GHE-specific E&T

  • Many subject-matter experts recognized a need for providing a range of GHE instruction not only to GHE specialists but also to members of the larger medical/health community, as well as some nonmedical personnel.

GHE development pathways are not systematically established

  • Although GHE courses are available to those at all career stages, most appear to target the midcareer stage, and avenues for GHE professional development have not been fully fleshed out, even for specialists.

Few recommended courses have GHE-specific content, limiting the exposure of nonspecialist DoD personnel to GHE concepts and practices

  • Workshop participants indicated that the greatest need was in exposing a wide range of DoD medical/health professionals to basic GHE concepts during their regular professional military education.

There is no explicit division of curricular responsibility among course providers

  • Joint medical providers offer the most GHE-specific E&T opportunities, and service medical providers largely offer foundational E&T courses with limited GHE-specific content. Some joint nonmedical organizations offer non-GHE-specific courses that are nevertheless useful to GHE practitioners.

GHE is conducted with limited strategic and policy integration of E&T elements and joint development of E&T policy

  • There are significant interrelated challenges that inhibit the development of GHE E&T, including a lack of resources (personnel and funding), insufficient policy requirements, varying support for GHE among important GHE stakeholders, and an inability to demonstrate the importance of GHE to achieving DoD objectives.

Recommendations

  • The Office of the Assistant Secretary of Defense for Strategy, Plans, and Capabilities should revise DoD Instruction 2000.30 to drive the requirement for providing and tailoring GHE E&T to the broader DoD health and security cooperation communities and to GHE specialists.
  • The Joint Staff should work to make GHE a “special area of emphasis” for joint professional military education, requiring the insertion of GHE content into security cooperation and leadership courses.
  • The Army Surgeon General should establish a program or programs for nonveterinarian Army personnel to develop GHE professionals.
  • The combatant commands and the services should review their medical/health billets for GHE workforce relevance and determine required GHE competencies for these billets to meet combatant command requirements.
  • Joint and service medical E&T providers should establish a working group to determine gaps and overlaps in the GHE content of medical professional development (especially, medical planners') courses and consider course modifications that increase the medical community's exposure to GHE.
  • Service GHE programs should develop service requirements for joint basic and intermediate GHE E&T and determine appropriate delivery mechanisms.
  • The GHE Council, representing major stakeholders from across DoD, should develop and publish a tiered implementation framework for GHE education, training, and professional development.

This research was sponsored by the Office of the Assistant Secretary of Defense for Health Affairs and conducted within the Personnel, Readiness, and Health Program of the RAND National Security Research Division (NSRD).

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