The Hardest Job You'll Ever Do

Prior to the Vietnam war, the families of American service members who lost their lives while on duty were notified via telegram. This policy changed in 1965 to the current method, which requires the notification to occur face-to-face with a service member, referred to as a Casualty Notification Officer (CNO), and chaplain present to provide immediate emotional support to the grieving next of kin (Galloway, 2004). The service members assigned to this duty serve in the same branch of service as, and hold a rank equal or senior to, the deceased. Later, the Department of Defense determined a need for additional support beyond the initial notification establishing the Casualty Assistance Officer (CAO). This service member, who adheres to the same branch and rank requirements as a CNO, assists a family’s transition through the death. Their work includes assisting with military funeral coordination, scheduling appointments related to financial changes, and serving as a line of communication between the military branch and the next of kin (Department of the Army [DA], 2007, p. 37).

In 2006, the Army implemented a formalized Casualty Notification Officer/Casualty Assistance Officer (CNO/CAO) training program for soldiers who attained mid- to senior-grade ranks; the enlisted ranks of Sergeant First Class to Sergeant Major, warrant officer ranks of Chief Warrant 2 to Chief Warrant 5, and the officer ranks of Captain to General (DA, 2007 p. 38). The training program includes an initial, in-person twenty-hour course and an annual online recertification course. The in-person, classroom-based training educates learners on the expectations and requirements of the CNO/CAO duty, and includes videos intended to highlight the gravity of the duty and its inherent emotional unpredictability with actors portraying scripted scenarios and personal testimonies (Gregg, 2006). The subsequent, online recertification training is required annually following the in-person course. (“CMOAD Interactive Casualty Training,” 2020).

Training Purpose

The Army’s CAO/CNO training program was established as a result of inconsistent support provided to surviving next of kin. While some surviving family members felt well supported by the Army following a soldier’s death, others did not (Gregg, 2006). A key element of improving this support was making soldiers comfortable with displaying emotion instead of rigidity (Gregg, 2006). The training enables soldiers to get, “more in touch with the human aspect of honoring the fallen” (Vergun, 2014). Though soldiers assigned as a CNO or CAO are not required to provide grief counseling, elements of the duty require a similar navigation of challenging emotions and empathy.

Challenges

Curriculums dedicated to grief training remain infrequent and inconsistent. Surveys of licensed counselors, to include marriage, family, and rehabilitative specialists, reveal more than half received no training on grief through their graduate programs (Ober, Granello, & Wheaton, 2012, p. 2). The same study states, “The content of grief counseling courses and professional development programs has not been thoroughly investigated, nor do guidelines exist for topics or objectives of grief counseling training” (p. 10). This has resulted in specific occupational fields developing independent curriculums to provide the necessary grief management and navigation skills.

The propriety nature of U.S. Army training development prevents me from verifying the methodology used in the CNO/CAO course’s design. Grief training for medical professionals is designed to provide knowledge about encountering grief in addition to legal and administrative issues related to death, to include death notification (Sikstrom, L. et al, 2019, p. 8). This mirrors the requirements and purposes of the Army’s CNO/CAO course. A curriculum developed by Dr. Karen Kavanaugh (2010) and her colleagues for palliative care nurses, which utilizes the Kolb Experiential Learning Cycle, closely aligns with the structure of the Army’s CNO/CAO course in both training materials and its blended delivery method.

Kolb Experiential Learning Cycle

The Experiential Learning (EL) theory developed by David Kolb describes learning as a process based on transformative experiences. It is a four-stage process, typically presented as a sequential cycle where each stage supports the next (McLeod, 2017).

Concrete Experience

The Kolb learning cycle traditionally begins with presenting a “concrete experience” to students. It provides an experiential foundation for learners and should be designed to activate learning related to the lessons that will be presented. They are often included in curriculums as “ice breakers” or games but can occur through problem-based discussion. If used at a later point in the curriculum, a final project or debate can provide the same experience (“David Kolb,” n.d.).

Both the U.S. Army’s CNO/CAO course and the grief training curriculum developed by Kavanaugh (2010) use videos as the experiential starting point for individual modules throughout the training. Those videos use scripted scenarios and personal testimonies of soldiers that have served as CNO or CAO, chaplains, and the family members of deceased soldiers (Gregg, 2006). This provides students an opportunity to witness the tasks at hand, which includes a CNO and CAO interacting with a grieving family member and managing their own emotional perspective of the assignment. Using media that presents authentic emotions in both the scripted scenarios and testimonies are much more “powerful” for students and humanize the experience (Kavanaugh, et al. 2010).

Reflective Observation

The reflective observation stage requires students to consider the concrete experience. Under Kolb’s theory, this stage is focused on determining and answering questions both internally and as a group. This is encouraged by asking for feedback or opinions from students, or even allowing a break from training to enable personal consideration of the concrete experience (“David Kolb,” n.d.). Within the CNO/CAO course, it is driven by the training facilitator through open discussion. Discussion covers the actions and emotions displayed in the videos and felt by the students (Gregg, 2006).

This integration of discussion topics–emotions with regulatory requirements, or emotion and logic–enable contemplative listening in learners (Cavanaugh, 2017) and aligns with recent studies which indicate cognitive activation occurs with emotional activation (Darby, 2018). Contemplative listening requires interpersonal trust and an ability in learners to set aside personal interest for that of the speaker (Cavanaugh, 2017). This is a beneficial trait for service members performing as CNOs or CAOs and activating the ability within the curriculum improves internalization of the material.

Abstract Conceptualization

The presentation of information that contextualizes individual modules and educates learners on what is witnessed during the concrete experience stage occurs during the abstract conceptualization stage. In Kavanaugh’s, et al (2010) grief training curriculum for palliative nurses, for example, students were provided excerpts from textbooks, journals articles, and similar materials on death, grief, and loss. In the CNO/CAO course, service members review and discuss the psychological stages of grief (Gregg, 2006), Army regulations, and examine copies of the forms used by CAOs during their duties, which include financial and disposition of remains documents.

This stage requires learners to connect what they witnessed with what they are learning, internalizing and confirming their interpretation of those connections to gain understanding (“David, Kolb,” n.d.). Students analyze the combination of experiences and reflections from the previous two stages and develop individual conclusions based on newly presented information (McLeod, 2017). In both the palliative nurse curriculum and the CNO/CAO course, these connections allow students to determine their own application of the taught principles as they anticipate their own navigation of grief and discussions with grieving family members (Kavanaugh, et all, 2010).

Active Experimentation

The final stage is an application of the internalized conclusions developed in the previous stage, enabling students to exercise independent understanding of the material in an authentic context (“David Kolb,” n.d.). This can be done through projects, assignments, or simulations and roleplay. During the in-person portion of the CNO/CAO course, this is achieved through small-group roleplay where students perform the roles of service members and next of kin. An additional written assessment focused on regulatory requirements of the duty serves as a more traditional application of knowledge. This provides trainers evidentiary validation that individual soldiers possess the knowledge required to perform as a CNO or CAO. The active experimentation stage is extended annually through the Casualty Simulation Immersion Training (CSIT) online recertification course, providing learners an opportunity to test the learned principles without repeating the in-person class. The CSIT, as an independent learning tool, effectively leverages game-theory principles to fully support the active experimentation stage.

Casualty Simulation Immersion Training

The CSIT recertification is presented as a roleplay simulation, where the student communicates with a virtual next of kin through dialogue choices. The student is required to complete three scenarios: one as a CNO, and two situated at various points in time as the CAO. Dialogue choices are evaluated on both factual accuracy, emotional awareness, and professionalism. The next of kin is presented through video and responds to dialogue choices with various grief-related emotions, including anger, disbelief, sadness, and apathy. Optional feedback is provided to each dialogue choice is also available; displayed in visual gestures such as a thumbs up or shaking their head, “no.” Resources, such as regulations and checklists, are accessible from the interface as well.

This design fully activates individual experimentation in a game-based learning tool. It relies entirely on an interactive structure and incorporates both emotional responses from the presented next of kin, and logical feedback from the feedback window. The feedback window also serves as a scaffold with the available resources. The incorporated assessment of these interactions provides evidence to infer the application of learned knowledge through the interaction and elicited behavior from the student (Van Eck, Rieber, & Shute, 2018, pp. 281-282). This validates that an individual soldier is capable of serving in the appropriate manner as a CNO or CAO.

Conclusion

Soldiers performing as a CNO or CAO create a lasting impression about the Army for the next of kin of deceased service members (Gregg, 2006). The application of the Kolb’s Experiential Learning Cycle, supported by interactive simulation of the CSIT to prolong the Active Experimentation stage, within the curriculum allows soldiers to learn and maintain the cognitive and emotional skills necessary to best perform the duty.

References

CAVANAUGH, J. C. (2017, January 27). You Talkin’ to Me? Chronicle of Higher Education, 63(21), A48. Retrieved from EBSCOHOST: https://login.oclc.fullsail.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=120979504&site=ehost-live

“CMAOD Interactive Casualty Training.” (2020, June 22). U.S. Army Human Resources Command.https://www.hrc.army.mil/content/CMAOD%20Interactive%20Casualty%20Training

Darby, F. (2018, January 3). Harness the power of emotions to help your students learn. Faculty Focus.https://www.facultyfocus.com/articles/teaching-and-learning/harness-power-emotions-help-students-learn/

“David Kolb.” (n.d.) University of Leicester.https://www2.le.ac.uk/departments/doctoralcollege/training/eresources/teaching/theories/kolb

Department of the Army. (2007, February 28). Army casualty program. U.S. Army. Retrieved through Military OneSource: https://www.myarmyonesource.com/cmsresources/Army%20OneSource/Media/PDFs/Family%20Programs%20and%20Services/Family%20Programs/Deployment%20Readiness/Operation%20READY/Smart%20Book%20Files/Reg600-8-1_Army_Casualty.pdf

Galloway, J. (2008, February 25). Rest in peace, Julie Moore. McClatchy DC.https://www.mcclatchydc.com/opinion/article24476953.html

Gregg Zoroya. (2006, October 30). Army focuses on better relations with next of kin. USA Today. Retrieved through EBSCOHOST: https://login.oclc.fullsail.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=J0E300821462506&site=ehost-live

Kavanaugh, K., Andreoni, V. A., Wilkie, D., Burgener, S., Buschmann, M., Henderson, G., Hsiung, Y., & Zhao, Z. (2010, May 19). Developing a blended course on dying, loss, and grief. Nurse Education,34(3), 126-131. Retrieved through NCBI: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2873156/

McLeod, S. A. (2017, October 24).  Kolb - learning styles. Simply Psychology. https://www.simplypsychology.org/learning-kolb.html

Mott, Z. (2017, June 9). CNO/CAO training [image 2 of 3] [image]. Defense Visual Information Distribution Service. https://www.dvidshub.net/image/3478359/cno-cao-training

Ober, A. M., Granello, D. H., & Wheaton, J. E. (2012). Grief Counseling: An Investigation of Counselors’ Training, Experience, and Competencies. Journal of Counseling & Development, 90(2), 150–159. Retrieved through EBSCOHOST: https://login.oclc.fullsail.edu/login? url=http://search.ebscohost.com/login.aspx?direct=true&db=pbh&AN=78110968&site=ehost-live

Sikstrom, L., Saikaly, R., Ferguson, G., Mosher, P. J., Bonato, S., & Soklaridis, S. (2019). Being there: A scoping review of grief support training in medical education. PloS One, 14(11), e0224325. Retrieved through EBSCOHOST: https://login.oclc.fullsail.edu/login? url=http://search.ebscohost.com/login.aspx?direct=true&db=cmedm&AN=31774815&site=ehost-live

Tibor, T. (2020, May 10). U.S. Army Casualty Notification Training Video [video]. YouTube.https://youtu.be/Vv4ohC3ABv0

Van Eck, R., Rieber, L., & Shute, V. (2018). Leveling up: game design research and practice for instructional designers. Trends and issues in instructional design and technology. 277-282.

Vergun, D. (2014, March 12). Casualty notification process emphasizes dignity, respect. U.S. Army.https://www.army.mil/article/121623/casualty_notification_process_emphasizes_dignity_respect