GRAFENWOEHR, Germany - U.S. Soldiers assigned to the Headquarters and Headquarters Company, 56th Stryker Brigade Combat Team, 28th Infantry Division, Pennsylvania National Guard, supporting the Joint Multinational Training Group-Ukraine mission, participated in a weekly mass casualty triage wargame at Grafenwoehr Training Area from Jan. 14 to Feb. 4.
Each medical squad of three to four combat medic specialists took a turn playing through the exercise during each week of the training period.
The 56th SBCT brigade surgeon, U.S. Army Lt. Col. Urlin Mathews, developed the wargame in 2022 when he was a U.S. Army War College student. In studying the U.S. Army War College’s wargaming elective course, Mathews learned the history of wargaming and how these games can effectively address military decision-making. His resultant medical wargame, developed alongside a U.S. Army War College mentor, focuses on strategy and decision-making in a medical field environment.
“My wargame is a resource allocation, or ‘European,’ game. Examples of such games are Scythe [and] Settlers of Catan,” said Mathews. “These types of games, and thus my wargame, are most useful for exploring resource-focused decisions, planning and processes where direct combat is not the emphasis.”
The medical wargame addresses mass casualty triage in a large-scale combat operations environment where medical personnel face limited access to medical supplies and air evacuation assets while treating an influx of patients.
Mathews said this wargame exposes medical personnel to simulated situations where they are never out of harm’s way. In the multi-week playthrough, the wargame’s senior medic, played by a squad leader, leveraged limited medical supplies, time and staff with immediate, delayed, minimal and expectant needs described on simulated patient casualty care cards.
Each game turn then brought additional simulated wounded patients to the scene, depicting the reality of a mass casualty situation. This stretched the limits of the medical team’s capabilities even more. The senior medic fought against mission failure by too many minimally injured simulated patients not returning to the battlefield in specified timeframes.
Sgt. 1st Class Michael Hansen played the role of the game adjudicator each week of the wargame exercise. He maintained the game’s sequence, ensured that events occurred according to the rules and mentored teammates playing the roles of senior and junior medics.
“When we have actual casualties on the battlefield, they’re not going to wait until we’ve worked through the ones that we currently have; they’re going to just keep coming,” said Hansen. “While we had opportunity this game to take our time and work through [the casualties], we do need to hone our skills and speed up so we can get patients out for when we are in an actual situation handling real patients.”
By the end of the four-week playthrough, Mathews found that his wargame successfully combined the 56th SBCT medics’ treatment knowledge with exposure to scenarios they might experience in large-scale combat.
“I couldn’t have been more pleased with the medics’ level of participation, enthusiasm and cognitive learning executing this ‘MASCAL Triage Educational Game.’”
Each of the 56th SBCT medical squads achieved the intended outcome of the game by working together through complex medical and logistical challenges to identify and treat casualties requiring evacuation from those returning to duty to accomplish the mission.
“I think what is really inspiring is [our] medics are already imagining how they can make the game harder and more realistic,” said Mathews. “[They are] calling the new injects as ‘expansion sets’ for future gameplay!”
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