WORCESTER—On a recent afternoon, the Richard J. and Sophia Catrambone Health Sciences Center at Assumption University was transformed into a simulated trauma zone, as physician assistant students took part in Tactical Combat Casualty Care training led by United States Army personnel — a hands-on exercise rooted in the military origins of their profession.
The physician assistant field itself emerged from a moment of national crisis. In the 1960s, the United States faced a severe physician shortage, while medics returning from the Vietnam War brought advanced trauma skills that exceeded the scope of civilian paramedic roles. At Duke University, doctors began enrolling those veterans in an accelerated medical education program, giving rise to the PA profession.
That military legacy continues to shape modern training, including at Assumption, where tactical medicine remains part of the curriculum. As part of their general surgery course, PA students recently completed Tactical Combat Casualty Care (TCCC) training under the guidance of Army personnel, including Gary Senecal, an associate professor of human services and an Army Reserve captain with 13 years of military service.
“This course is designed to be at the end of the didactic year, after students have had some emergency medicine and surgery classes,” said Christopher Ferreira, PA-C, program director of PA studies, in an Assumption University announcement. “This knowledge can be applied to any setting, but it’s what the military uses to train field trauma. Instead of doing things the way we normally would when everything’s nearby, this is training for situations you need to address emergently to save someone’s life.”
The training unfolded over two days. The first focused on classroom preparation, while the second placed students into a simulated mass-casualty scenario involving blast and burn injuries following an explosion. Half of the class portrayed injured patients scattered outside the health sciences center, while the remaining students formed rescue teams tasked with locating, transporting, triaging, and treating them.
“The scenario had half the class scattered outside Catrambone, waiting to be treated. The other half of the class was the rescue team,” Ferreira said. “Those students would go out, find people, bring them into the lab on the third floor, triage them, and run the floor like a triage hospital.”
Undergraduate nursing students, accelerated bachelor’s nursing students, members of Assumption’s Pre-PA Club, and other undergraduates participated as mock patients, complete with simulated injuries created using makeup. Massachusetts Maritime Academy provided an ambulance, while a UMass Life Flight helicopter landed on Rocheleau Baseball Field, giving students the opportunity to observe its equipment and speak with the flight crew.
Among those helping to facilitate the exercise was PA student Veronica Leonardo, a military medic in the Rhode Island Air National Guard with a decade of experience leading similar trainings.
“I was excited to have my class see what my background is and how the military functions,” Leonardo said in the release. “At the same time, I was a little nervous—I do this with the military, but it’s different when you’re doing it with your own classmates.”
Leonardo was one of four PA students in leadership roles during the exercise. Allison Solomon, a former EMT with six years of experience, and Allison Florentino, who worked in athletic training for a decade, each led one of the two teams. Olivia Gamache, a paramedic with 10 years of experience and the current PA class president, assisted with triage alongside Solomon and Florentino.
Being divided into two groups allowed students to learn from each other in real time, Gamache said.
“The first group didn’t have anything to emulate; they responded in the moment,” Gamache said in the announcement. “The second group observed and tried something different to see if it was better. That’s how it’s supposed to happen—you learn from everything and build upon that knowledge.”
“When you’re going out into the field, and you get activated, you’re not going to have pre-planning or preparation. It’s chaos, but you will figure it out,” Leonardo said.
“That’s the point of the scenario,” Solomon said. “To fail, and have it be messy, especially when nobody’s actually dying, so we could learn.”
Florentino emphasized the value of exposure to emergency medicine for all future providers.
“Emergency medicine is something that should be important to all medical providers,” she said. “I’d rather be overprepared by having done something like this than underprepared and in a state of shock when seeing it. You never know where or when something is going to happen. Catrambone was set up as our treatment center, and was it ideal? No. But the training, for me, was about learning how to adapt to make it the best possible situation.”
“If you can learn to care for patients with the bare bones, it makes you a better provider,” she continued.
In January, Assumption’s inaugural PA cohort transitions from classroom instruction to 16 months of off-site clinical rotations. Leonardo will complete an orthopedic surgery rotation in Rhode Island; Florentino will train in inpatient medicine at UMass Memorial Health – Harrington Hospital; Solomon will begin ophthalmology and ear, nose, and throat rotations; and Gamache will travel to Block Island for family medicine. Each rotation will last five weeks, with students cycling through 13 clinical sites.
A new cohort of PA students also begins at Assumption in January and completes the same TCCC training at the end of their didactic year. Leonardo plans to help lead the exercise again, and Ferreira said second-year students are eager to assist after finding the training so impactful.
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