Optimizing the Self-Directed Training Kiosk for Tactical Combat Casualty Care Skills Among Chinese Military Service Members: A Kano Model Approach

ABSTRACT Introduction Tactical Combat Casualty Care (TCCC) is widely recognized as the gold standard for reducing preventable battlefield deaths. Although the People’s Liberation Army has incorporated TCCC into its training programs, traditional instructor-led methods face challenges in addressing personalized learning needs and are often constrained by limitations such as time, venue, and faculty availability. To overcome these challenges, a self-directed TCCC training kiosk was developed. This study applies the Kano model to analyze user requirements among Chinese naval personnel, aiming to guide optimization strategies and provide valuable insights for driving innovation in military medical education. Materials and Methods A mixed-methods approach was adopted, starting with a literature review and semi-structured interviews with 10 naval medical personnel. Based on the findings, a Kano model-based questionnaire comprising 5 dimensions and 45 requirements, along with a satisfaction evaluation of the self-directed TCCC training kiosk, was developed. The survey was conducted with 305 personnel from a Chinese naval unit, and the data were analyzed using SPSS 26.0 to classify user requirements into 5 Kano attributes. Better-Worse coefficients and a 4-quadrant analysis were then applied to effectively prioritize these requirements. Results A total of 264 participants responded to the survey, with 66.7% reporting being very satisfied with the self-directed training kiosk. The Kano model analysis revealed that over half of the requirements were classified as indifferent (25/45, 55.56%), followed by 11 as one-dimensional (24.44%), 6 as must-be (13.33%), and only 3 as attractive (6.67%). Notably, none of the requirements were categorized as reverse. The requirements were prioritized across 5 key dimensions: environmental settings, management and support, equipment and facilities, self-directed training functions, and system features, providing a strategic framework for optimizing the training kiosk. Conclusions This study provides valuable insights into the application of user-centered design and technology-enhanced learning in military medical education. The findings underscore the potential of self-directed learning to improve the quality, accessibility, and effectiveness of TCCC education, ultimately enhancing the preparedness of Chinese naval medical personnel to deliver life-saving care in combat scenarios.