Expeditionary medical diplomacy: A formative evaluation of the International Health Specialist program

The International Health Specialist (IHS) program is a United States Air Force Medical Service initiative designed to facilitate the use of medics internationally in a variety of roles utilizing knowledge of skills of expeditionary medical diplomacy. The IHS program exists in a matrix organization structure, which involved a geographically dispersed population of personnel delivering services worldwide. As this program is new, this study is a formative evaluation, specifically focusing on the degree to which the objectives of the IHS program were being met and how they were being met.; Specific activities in any program are reflective of actual policy implementation. Overall, the literature suggests that there will be implementation failures in a new, dynamic organization that is to some degree forming itself. This study addresses the effectiveness of these initial program implementation activities. Data were collected via a review of teleconference minutes and an Internet survey to describe roles assumed, knowledge and skills of personnel, tasks and activities performed, education and training of members, relationships formed with others in health care systems throughout the world, and strategies used to achieve program objectives.; IHS personnel were found to assume several overlapping roles: a military war-winning role as advisors to Combatant Commanders, a relationship building role that involved coordination of multiple organizations, a clinical role that provided humanitarian assistance, an educator role that promoted medical interoperability, and administrative and evaluator roles in relationship to program implementation.; This research has also found that medics are effective as instruments of national policy through relationship building activities and multilateral activities. The literature suggests that a complex program of this nature within an organization that has a high level of turnover would have little chance of success. However, the achievements experienced by the teams can be attributed to the development of military medics who are professional, autonomous, pragmatic, and trained to take initiative and work on their own in cooperation with available resources. With personnel structurally separated in a matrix organization, however, there is a lack of a systematic strategy among IHS teams to address overall program goals, which has resulted in problems in program implementation. Results of this study related to organization structure, management of information, personnel development, and communication strategies could be used to further the effectiveness of program implementation.