We regularly met with our software designers and the Reconnaissance Marines instructors as well as our research team to design and test versions of the app. The ResearchKit app enabled us to conduct a research study on an entirely digital platform, including the ability to consent subjects on their iPhones, and to custom design a Reconnaissance Marine app that served as the interface to the subject for collection of daily surveys.
Apple Watch data were collected using HealthKit, which provides the ability to collect Watch data and integrate it into the dataset collected on ResearchKit. In the future, we will leverage HealthKit to integrate other connected sensors such as weight, oxygen saturation, or temperature. As data in this study were continuously collected over the entirety of training days, we were also able to internally validate the heart rate measures by comparing daytime with nighttime readings, which were consistent with typical circadian variability of heart rates observed in a young, healthy male population [ 52 ].
The ability to perform research studies in a continuous model of data collection evolves the research model to one that is much more comprehensive and efficient than traditional models that focus on data collection during a single discrete study interval and are performed under more artificial and less naturalistic conditions than being embedded within the actual training environment being studied. It is particularly important to collect data for military populations while they perform their normal functions, which often include stressful conditions that are not easy to reproduce in a laboratory setting.
Other benefits of this model include the ability to more quickly and efficiently translate study findings into interventions that can be tested in the subsequent classes. For example, our finding that declines in both daily self-reported emotional and physical pain scores and confidence in graduating preceded DORs from training provide an opportune target to build and test interventions. In addition, the finding that most DORs occurred in relation to an aquatic training event suggests that these events are causing significant doubt, distress, and lack of confidence.
The finding that individuals who completed the course manifest more positive affect suggests that an effective intervention should instill these traits and behaviors. Ideally, an intervention targeted at cultivating confidence for these activities will heighten the probability of successful completion without changing the rigorous nature of the training itself. This could include specially designed educational or motivational video content, which is delivered to the trainee manifesting these thoughts and feelings, through the next version of the study software app.
Similarly, advances in technologies, such as the real-time electrocardiogram ECG capability on the Apple 4 Series Watch, can be easily integrated into the study and provide another opportunity to validate the heart rate data. These ECG and heart rate capture capabilities may provide a real-time safety component for these trainees, while undergoing intense physical training. For instance, if a trainee sustained a very elevated heart rate, this could be validated by obtaining an ECG from the Watch and displayed to instructors in real time, using a CareKit-enabled data dashboard, which could then allow for timely medical assessment of that individual.
We have designed and implemented a flexible and continuous research model for military training that can easily accommodate best-in-breed sensors, allow for rapid software integration to more efficiently assess and test novel training interventions, and increase the course completion rate and quality of new Reconnaissance Marines and other military equivalents. This model can also provide important efficiencies and data flow that will help assess the medical well-being of trainees.
We also found that despite the physical rigor involved in Reconnaissance Marine training, most of the attrition is due to mental deterioration rather than physical deterioration, and students who DOR often do so outside of the deepest physical stressors, that is, while on the pool deck as opposed to actually being in the pool. These signs of deterioration can be identified before trainees withdraw or are withdrawn from training, and interventions that target the reversal of these feelings as well as help to gain a deeper understanding of how to determine selection criteria can be designed.
We did not collect data on the entirety of the courses offered by the Reconnaissance Training Company, namely, the follow-on day BRC that follows the day BRPC, which limits our ability to draw conclusions about fully graduating into the Reconnaissance military occupational specialty.
We also did not collect any data on weekends, mostly due to initial study design limitations with maintaining the study equipment inventory of iPhones, Watches, and data plans, which can be addressed through improved battery life and study design, leading to a model capable of measuring students during the entirety of trainee experience, including time off and personal time. Daily questions Multimedia Appendix 1 inquiring about substance use were only included in the second and third cohorts and inquired about nicotine and alcohol but not caffeine and other substances known to affect performance.
In addition, the response scales were not standardized. For these reasons, the data were not analyzed and are a limitation in this study design. Future research should include a more comprehensive and standardized assessment of substances known to affect performance.
Although the Apple Watch has been validated in other studies [ 7 , 18 , 19 , 53 ], there were a number of possible limitations. Although Apple does not promote a specific sleep analysis feature, heart rate data have been known to correlate with sleep patterns, and recent research has begun to validate the use of raw Apple Watch heart rate data to derive sleep duration [ 54 ].
One limitation was the range of heart rates that the Apple Watch is technically able to collect, which consists of a minimum of 30 BPM and a maximum of BPM, as highlighted in Table 3 [ 37 ].
For instance, an individual could register a heart rate of 30 BPM, such as a physiological pause after a premature beat. Similarly, a high heart rate recorded at BPM would not necessarily mean that the heart rate was sustained at this level but that it was sustained enough to register at the upper limit.
The frequency of low or high heart rate events depends on the frequency of sampling at a higher rate in workout mode every 5 seconds versus regular mode every 5 min.
The fact that we reported within our range values both very low and very high step counts and energy expenditures is a result of a number of factors. If a trainee was removed from training early, spent the day in a classroom, or did not enter the workout mode, this would account for low step count and energy expenditure.
For these reasons, we feel that the mean values are more reflective of the data. However, to control for these limitations, an additional and different wearable sensor with a wider range of data collection capabilities can be used in future studies in conjunction with the Apple Watch to further compare data. Owing to the nature of military training, another limitation is that the number of subjects per group is highly unequal.
To address this, we combined data from the 3 cohorts across groups to create larger sample sizes. In the future, we will require additional cohorts to increase the sample size and validate the results. Another possible limitation of our study is the use of self-report surveys, which can be prone to bias or misreporting.
However, other studies in military populations have used the same or similar personality and behavioral self-report surveys [ 8 , 11 - 13 , 15 , 23 , 25 , 26 ]. Although we agree that self-assessment is not generalizable, our ability to obtain daily individual measures of mental and behavioral status, we feel, was a great strength in this study. Furthermore, we recognize that all observational research has the potential for bias to some degree, but we feel as though this research is crucial in contributing to human performance knowledge by not disrupting the natural training environment of these elite warfighters.
This study demonstrates the feasibility and accuracy of actionable data that can be collected using a natural, continuous, and holistic model of data collection using a modern digital platform, custom-made software, and body-worn sensors. This model of innovation has the potential for rapid discovery in military training environments that may lead to better training and selection of military personnel and translate into other elite training environments.
In addition, the data paint a novel picture of the mind and body processes in determining performance outcomes—findings that can generalize into any high pressure, competitive domain. The authors are deeply indebted to the leadership of the Reconnaissance Training Company at the School of Infantry-West SOI-W at Camp Pendleton for their partnership, ideas, and numerous hours spent teaching the authors their objectives and needs. These crucial interactions enabled the authors to design a study targeted at meeting real objectives efficiently.
The authors are also grateful to the leadership of the SOI-W for supporting this line of research. Rates of successful course completion and failure to complete by category for all 3 classes. DOR: drop on request. Edited by G Eysenbach; submitted Skip to Main Content Skip to Footer. Article Authors Cited by 4 Tweetations 17 Metrics. Original Paper. Table 1. Baseline demographics of study subjects. Table 2. Study metrics by collection method. Table 3. Mean heart rate beats per minute per group course completion and all noncompletion categories compared by time of day.
Table 4. Mean activity daily steps per group course completion and all noncompletion categories. Group Mean SD Range Pass daily steps 10, , Drop on request daily steps , Medical daily steps , Safety daily steps , Performance daily steps , Table 5. Are you looking to pursue a career in the Marine Corps or Navy special forces?
Marine Reconnaissance units are some of the most elite warriors in an already superior fighting force. Recon Marines gather information through reconnaissance and surveillance missions deep behind enemy lines. Recon Marines have a military occupation specialty code of This training will cover everything from ocean swimming to helicopter rope suspension and various reconnaissance training.
Those who pass get additional specialized training before heading out on missions around the world. But attendance at BRC also appears to be on the decline and has not peaked above candidates since , according to data obtained by Marine Corps Times.
Manpower issues are also coupled with high attrition rates and lower attendance rates at the Basic Reconnaissance Course. As a result of the working group, BRC will now have 11 additional days of instruction. Some former and current recon Marines posit the decline in attendance at BRC may be a result of the primer course weeding out students who otherwise would not have graduated BRC.
And Corps officials said since the new screening course and changes to BRC went into effect graduation rates have soared to nearly 80 percent. Your Marine Corps. By Shawn Snow and Andrea Scott. Oct 8, The Corps is dishing out big bonuses for grunts and other jobs. Want to be a Marine special operator? Once a special operations forces Marine Raider in Afghanistan, year-old veteran Jason Lilley has had to work through feelings Special Operations.
The course consists of three phases: Phase 1 is four weeks long and focuses on Marine individual physical skills such as running, high-repetition PT, obstacle courses, ocean swims with fins, rucking, land navigation, helicopter rope suspension training, communications and supporting arms.
Phase 2 is three weeks long and concentrates on small unit tactics, mission planning and includes a nine-day exercise in full mission profiles. Phase 3 is two weeks and focuses on the maritime mission. Held in Coronado , California, the Marine will conduct amphibious reconnaissance, boat operations and nautical navigation.
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