I was going through advanced training with the tactical team that I had recently joined to provide medical support. I was very excited to make the team and wanted to put my best foot forward. We were at a large training facility where all training is performed using simunition, or paint rounds in the weapon systems.

The medical support personnel carry weapons should they have a need to defend themselves. However, we also would perform the same task as everyone else. I would imagine this was largely for team building and confidence. While many of the skills do not transfer directly for medical providers there are translatable lessons that can benefit these drills. 

The current evolution was a simulated hostage rescue in a commercial jet, with “green man” targets being hostages and white silhouette targets being hostiles. I entered the cabin with a seasoned SWAT officer and we began clearing the area. We found a main cabin filled with simulated hostages and a closed door to the cockpit.  We each engaged one hostile in our area of responsibility moving through the cabin. I had no issues target discriminating between friendly and hostile targets in this setting, but I had additional time to do so because the area was large and I had a full view from the time I entered.  

We then encountered a closed door leading to the cockpit. My partner quickly opened the door and I had first eyes in the room. What was revealed to me was a friendly silhouette with a hostile behind them exposing only their head and a portion of the chest. This is to simulate a person being held at gunpoint. I knew that time was of the essence. My eyes quickly focused on the front sight post of my handgun, making it appear crisp over the slightly blurred target. My right index finger moved from resting on the side of the gun, to the trigger and carefully but quickly increased pressure on the trigger until one round fired. I saw a paint round strike the target I had aimed at and it was a good hit! I quickly re-acquired a sight picture and fired another well-placed hit right next to the first - on the head of the target.

The instructor called out “index” signifying the end of the exercise. He complimented me on how quickly and accurately I fired the weapon, but then asked me why I shot the hostage. Looking up I could see two blue paint splotches on the head of the green silhouette.

What changed from the cabin to the cockpit? Is it fair to say there was internal pressure to perform flawlessly and act very quickly? Of course. It is this additional stress and pressure that can transition a person from the stressful situation of clearing the cabin area to something perceived as possibly threatening to neutralize a hostage-taker as quickly as possible. This is no different than what happens during the performance of critical tasks for medical providers.

Up to this point, I had served this police agency as a reserve patrol officer for the past 12 years. Each year I qualified at expert level for various weapons systems, using these same “green man” targets. What I failed to recognize this day was that this had left me with a conditioned response to shoot that target. In a situation with elevated stress and pressure humans will often default to that which is known. Should this default be an undesired action, we refer to this as a “training scar."

 

What Happens When We Process A Sensory Impulse

1. The impulse is channeled through our thalmus by our nervous system. 

2. The thalmus sends the information to our “thinking brain” to form a rational, organized response. At the same time, our hippocampus (responsible for cataloging old memories) searches for a similar scenario that we have already been through to test the response. 

 

Should this cognitive appraisal lead us to feel that we did not have the equipment, ability, and/or prior experience to handle the current situation we feel more threatened than simply challenged.Challenge or arousal can enhance performance to a point, but threats can cause a more emotional than rational response.This is very basic description of the process. The main point of this blog is to help provide understanding of training scars.How many times have you heard, or maybe said yourself:

 

 “I wouldn’t do this if it was a real incident."

 

These words almost always precede moving in the direction of training an undesired response. Humans have proven time and time again that under stress we will perform the way that we train.  For this reason, it is imperative that simulations be as realistic as possible, avoiding a development of bad habits.  This includes both cognitive and psychomotor tasks.  We should try to avoid simply “verbalizing” treatments or medications being administered.  It is important that we perform these skills in context to give useful prior experience to draw upon when time is of the essence. Please keep this in mind when developing training scenarios and your own mental simulations.

There is a happy ending to this story. We are not completely powerless when it comes to how we handle stressful situations. There will be more to come on this in subsequent posts from me. I hope that you have enjoyed this and that it helps you not set yourself up for failure. Fortunately for me, a couple of rounds later, a veteran officer made the same mistake. It is true that sometimes misery loves company!

              

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Episode 2 - White Hair Beads
The Rapid Sequence Interrogation Podcast

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