A physical demands analysis to identify and delineate critical physical tasks for physically demanding US air force occupations

Abstract

BACKGROUND:

Military physical fitness tests and standards often lack a scientific basis. Contrary to this traditional-historical precedent, US Air Force researchers use a “Two-Tier” health (Tier 1) and performance (Tier 2) approach to develop evidence-based criterion physical fitness tests, standards, and training. This study specifically and only addresses a physical demands analysis, the first step in a six-step process to develop Tier 2 occupationally specific, operationally relevant physical fitness tests and standards, and training guidance.

OBJECTIVE:

This study conducted a physical demands analysis to identify and delineate occupationally specific, operationally relevant critical physical tasks for eight physically demanding US Air Force occupational specialties.

METHODS:

A comprehensive five part physical demands analysis reviewed duty tasks, conducted focus groups, assessed incumbents, observed operational tasks, and interviewed senior leaders to detail critical physical tasks.

RESULTS:

The physical demands analysis delineated duty tasks to critical physical tasks for Special Tactics (556 to 40), Pararescue (981 to 50), Tactical Air Control (415 to 44), Special Operations Weather (586 to 50), Explosive Ordnance Disposal (1107 to 39), Security Forces (1286 to 25), Fire and Emergency Services (802 to 39), and Survival, Evasion, Resistance, and Escape (1099 to 25).

CONCLUSIONS:

The study approach proved efficacious for conducting a thorough physical demands analysis to identify and delineate occupationally specific, operationally relevant critical physical tasks for eight US Air Force physically demanding occupations. Critical physical tasks provide basis for the next overall research process step, developing physical task simulations to link to predictive physical fitness tests and training guidance.

Keywords

Task performance and analysis physical fitness occupations military personnel job task analysis physical performance

1 Introduction

Military physical fitness (PF) tests and standards often do not have a scientific foundation relevant to criteria such as health risk or operational duty performance. Additionally, standards are typically norm-referenced, with no inherent criterion basis, i.e., they do not indicate if a servicemember is healthy, able to perform their duties, or fit for deployment [1, 2]. In contrast to this traditional-historical precedent, US Air Force (AF) exercise physiologists recommended in 1998 a “Two-Tier” health (Tier 1) and performance (Tier 2) approach to the development of evidence-based criterion AF PF standards [1 –3]. This led AF exercise scientists to develop Tier 1 PF tests with professionally recognized health-based criterion standards for the aerobic and body composition components that the AF implemented in 2004 for all military personnel independent of military occupational specialty (MOS). A 2010 update ensured test scores reflected degrees of health and general fitness. However, in 2022 the AF regressed to normative standards with arbitrary scoring relinquishing the meaningful Tier 1 science basis [2, 4]. Whether science-based or normative, the AF Tier 1 PF tests and standards do not necessarily reflect task achievement. Therefore, an additional level of evidence-based PF tests and standards is required, i.e., Tier 2 occupationally specific, operationally relevant tests and standards based on physical duty requirements of physically demanding MOSs (Fig. 1).

Fig. 1

Tiered approach to developing science-based criterion PF tests, standards, and training.

The US Congress mandates the US Military Services create physical employment screening tests and standards, labeled as Tier 2 occupationally specific, operationally relevant tests and standards by the AF [4], when introducing new tests for more physically demanding MOSs [5]. More broadly, international military and civilian entities employ physical employment tests and standards for personnel selection, retention, and training for physically demanding occupations [6 –10]. These Tier 2 occupationally specific, operationally relevant tests and standards benefit physically demanding occupations by selecting and evaluating personnel for relevant physical capabilities and motivating personnel to physically train to improve duty performance [10 –12]. Tier 2 research and development should follow a bona-fide occupational requirements multi-step process to elicit scientifically and legally defensible tests, standards and physical training guides [1 , 13]. The AF Exercise Science Unit’s version of this process, the Tier 2 occupationally specific, operationally relevant six-step process for developing PF tests, standards and physical training guidance, is depicted in Fig. 2.

Fig. 2

AF Exercise Science Unit’s Tier 2 six step process to develop occupationally specific, operationally relevant physical tests, standards and physical training guidance. Step 1 indicates study portion addressed in this manuscript.

The first step in this Tier 2 occupationally specific, operationally relevant process is to conduct a job task analysis, or as some refer, a physical demands analysis, to elucidate the critical physical tasks (CPTs) of physically demanding AF occupations [10 , 13–15]. CPTs are defined as physical duty tasks that are both physically demanding and critical to mission success [2, 13]. Physical demands analysis methods vary and there is no singular choice of methodologies [11]; here the AF Exercise Science Unit performed a systematic physical demands analysis to identify and quantify the physical demands of critical and non-critical tasks of the first eight AF occupations listed in Table 1, prior to executing overall study steps two through six (addressed in later manuscripts) to develop occupationally specific, operationally relevant tests, standards and physical training guidance for career field use.

Table 1

US Air Force military occupational specialties grouped by physical demand

Note: Special Operations Weather is no longer an AF MOS. Replaced by Special Reconnaissance.

2 Purpose

The purpose of this study was to conduct a physical demands analysis to identify and delineate occupationally specific, operationally relevant critical physical tasks for eight physically demanding US Air Force military occupational specialties.

3 Methods

3.1 Study design

Since the physical demands analysis is foundational to the overall Tier 2 occupationally specific, operationally relevant process [10 , 16–18], the AF Exercise Science Unit’s Step 1 physical demands analysis was designed to identify and delineate CPTs from all recognized duty tasks within the eight occupations. This physical demands analysis is unique [11, 19] to the eight AF MOSs and is comprehensive, encompassing five subjective and objective sub-steps (below) found in part or recommended by others [2 , 14]

Review occupationally specific duty tasks to develop preliminary physical tasks.

Conduct subject matter expert focus groups (qualitative data).

Perform AF-wide, MOS-specific scoring assessment (quantitative data).

Observe physically demanding tasks in the field.

Interview subject matter expert leaders.

3.2 Sub-step 1A - review occupationally-specific duty tasks

Occupationally specific duty task lists were compiled from career field source documents, primarily MOS-specific Occupational Analysis Reports and Career Field Education and Training Plans, but also from AF Instructions, current doctrine documents, and training documents (plans of instruction, lesson plans). RAND Corporation’s report, “Fit for Duty,” [2] an analysis of AF Battlefield Airmen (now Special Warfare) for the four Special Warfare MOSs was used. Finally, AF Instruction 16–1301, “Operations Support, Survival, Evasion, Resistance, and Escape Program” [20], AF Instruction 32–2001, “Civil Engineering, Fire and Emergency Services Program” [21], and the National Fire Protection Association Guide [22] were additional documents used in this sub-step. Career fields provided a minimum of three experienced (i.e., have performed, supervised, and trained tasks) MOS-specific subject matter experts (SMEs) for this sub-step, each with an operational physical deployment within the last seven years, to work closely with the AF Exercise Science Unit research team in accomplishing this sub-step. Primarily the SMEs: delineated physical and non-physical tasks, described tasks in lay terms, and ranked tasks by physical intensity via Borg rating of perceived exertion scale [23]. SMEs used the Borg Scale with a baseline at level 6 of no exertion (sitting and resting) with remaining exertional levels color coded green (low, 6–11), amber (moderate, 12–16), or red (high, 17–20). Sub-Step 1A produced preliminary physical tasks (PPTs) for each career field.

3.3 Sub-step 1B - conduct focus groups

To define, delineate and narrow the MOS-specific PPT list, increase transparency and face validity with the career fields, and obtain qualitative data, SMEs participated in three-day focus groups (20 hours total) in Sub-Step 1B. Three focus groups per MOS (Special Warfare n = 58 across four MOSs, Explosive Ordnance Disposal n = 17, Security Forces n = 14, Fire and Emergency Services n = 19, Survival, Evasion, Resistance, and Escape n = 13 for two groups), were conducted with four to seven SMEs per group, each SME with an operational deployment within the last seven years. SMEs had a breadth of experience, obtained via diverse assignments, across the physical requirements of all major MOS-specific mission sets.

3.3.1 Stage 1: Pre-focus group

Prior to the focus group meeting, the MOS-specific PPT list was electronically mailed to the SMEs so they could identify and delineate tasks into subtasks using operational descriptors (verbs) and determine if the subtasks were physically demanding. PPT lists were organized by mission sets (Table 2) and assigned randomly within each focus group.

Table 2
MOS-specific mission sets

STO /CCT CRO/PJ TACPO/TACP SOW EOD SF FES SERE

Small Unit Tactics Small Unit Tactics Small Unit Tactics Small Unit Tactics Small Unit Tactics Law Enforcement Aircraft Travel Tactics

Close Quarters Battle Close Quarters Battle Close Quarters Battle Close Quarters Battle Individual Movement Techniques Flightline Security Confined Space Rescue Operations Static Tactics

Casualty Collection Casualty Collection Casualty Collection Casualty Collection Casualty Collection Nuclear Operations HazMat Personnel Recovery

Water Operations Water Operations Water Operations Water Operations Don/Doff Bomb Suit Defender Tactics Wildland Water Tactics

Parachute Operations Parachute Operations Parachute Operations Parachute Operations Reconnaissance Using Robotics Emergency Medical Services Parachute Operations

Fast Rope Insertion Extraction System Fast Rope Insertion Extraction System Fast Rope Insertion Extraction System Fast Rope Insertion Extraction System Active Range Clearance Operations Structures-Forcible Entry, Salvage, Overhaul

Rope Ladder Activities Rope Ladder Activities Rope Ladder Activities Rope Ladder Activities Rappeling Command and Control

Landing Zone Operations Personnel Extraction Vehicle Operations Mountaineering Operations Downed Vehicle Actions Vehicle Operations

Mountaineering Operations Climbing Procedures Prepare Deployed Locations Prepare Deployed Locations Contingency Airfield Support

Arctic Operations Personnel Extraction Disposal Site Preparation

Rig and De-Rig Equipment Radio Assembly Decontamination and Leak Sealing

Transport and Dispose of Explosive Ordnance

Locate, Identify, Render Safe Explosive Ordnance

Combatives

Protective Works

Excavation

STO /CCT	CRO/PJ	TACPO/TACP	SOW	EOD	SF	FES	SERE
Small Unit Tactics	Small Unit Tactics	Small Unit Tactics	Small Unit Tactics	Small Unit Tactics	Law Enforcement	Aircraft	Travel Tactics
Close Quarters Battle	Close Quarters Battle	Close Quarters Battle	Close Quarters Battle	Individual Movement Techniques	Flightline Security	Confined Space Rescue Operations	Static Tactics
Casualty Collection	Casualty Collection	Casualty Collection	Casualty Collection	Casualty Collection	Nuclear Operations	HazMat	Personnel Recovery
Water Operations	Water Operations	Water Operations	Water Operations	Don/Doff Bomb Suit	Defender Tactics	Wildland	Water Tactics
Parachute Operations	Parachute Operations	Parachute Operations	Parachute Operations	Reconnaissance Using Robotics		Emergency Medical Services	Parachute Operations
Fast Rope Insertion Extraction System	Fast Rope Insertion Extraction System	Fast Rope Insertion Extraction System	Fast Rope Insertion Extraction System	Active Range Clearance Operations		Structures-Forcible Entry, Salvage, Overhaul
Rope Ladder Activities	Rope Ladder Activities	Rope Ladder Activities	Rope Ladder Activities	Rappeling		Command and Control
Landing Zone Operations	Personnel Extraction	Vehicle Operations	Mountaineering Operations	Downed Vehicle Actions		Vehicle Operations
Mountaineering Operations	Climbing Procedures	Prepare Deployed Locations	Prepare Deployed Locations	Contingency Airfield Support
	Arctic Operations	Personnel Extraction		Disposal Site Preparation
	Rig and De-Rig Equipment	Radio Assembly		Decontamination and Leak Sealing
				Transport and Dispose of Explosive Ordnance
				Locate, Identify, Render Safe Explosive Ordnance
				Combatives
				Protective Works
				Excavation

Special Warfare: Special Tactics Officer (STO), Combat Control (CCT), Combat Rescue Officer (CRO), Pararescue (PJ), Tactical Air Control Party-Officer (TACP-O), Tactical Air Control Party (TACP), Special Operations Weather (SOWT). Explosive Ordnance Disposal (EOD), Security Forces (SF), Fire Emergency Services (FES), Survival, Evasion, Resistance, and Escape (SERE).

Operational descriptors, e.g., haul, drag, traverse, were used to retain operational reality and avoid describing the subtask with an exercise movement pattern, e.g., lift, push, pull. This was to dissuade the SMEs from assuming there was only one way to perform the subtask, e.g., hauling casualty from danger area versus carrying casualty from danger area. SMEs were provided instructions to:

Use bullet statements to break down and describe in lay terms tasks into subtasks

Use operational verbs. For assistance, please use the following operational verb list: Analyze, Apply, Assemble, Attack, Attach, Assist, Barricade, Board, Cast, Clear, Connect, Construct, Control, Cover, Defend, Detonate, Deploy, Derig, Descend, Disembark, Dismount, Displace, Demolish, Embark, Employ, Evacuate, Establish, Execute, Extract, Evade, Haul, Insert, Launch, Load, Maneuver, Mount, Move, Navigate, Operate, Recover, Remove, Rescue, Rig, Route, Search, Select, Submerge, Strap, String, Transport, Traverse, Transfer, Unload, Use, Vector

Assess tasks based on a “typical” (not an extreme or “Silver Star”) operational mission conducted within the last seven years, focusing on operations and not on training

Example

Task: Perform close quarter combat operations

Subtask 1: Clear entry way

Subtask 2: Maneuver around objects

Subtask 3: Move objects (furniture, people) to center of room

Subtask 4: Attack enemy forces

SMEs electronically mailed their completed list of responses to the AF Exercise Science Unit where it was compiled for the next stage of this sub-step.

3.3.2 Stage 2: Focus group day one

AF Exercise Science Unit focus group researchers were trained [24] in facilitation techniques by operations research experts from the AF Studies and Analyses Squadron, Randolph Air Force Base, and the facilitation team remained consistent across focus groups. In the first day of on-site focus group meetings the SMEs further described the PPTs and delineated them into subtasks with operational verbs until reaching group consensus. Facilitators guided the group per the following:

Determine if the task is physically demanding - focus group discussion and consensus

Confirm conversion, with operational verbs, of major tasks to subtasks that can be assessed objectively, understood with lay language, and assigned physical movement descriptors - focus group consensus

Determine if the subtask is physically demanding - focus group consensus

Delineate only those tasks that are the most physically demanding, i.e., only apply operational verbs to physically demanding tasks and associated subtasks; give less emphasis to low- or non-physical tasks, these tasks were documented by the AF Exercise Science Unit, but not included in follow-on Sub-Step 1C.

As above, SMEs were instructed to maintain operational rationale for tasks, to focus on the operational mission, not training, to avoid the circular argument of, “we do this because we have always done it in training.” After majority concurrence, tasks and subtasks were organized by the AF Exercise Science Unit within mission sets, with sets randomized for individual scoring.

3.3.3 Stage 3: Focus group day two

For further delineation, the tasks and subtasks were independently scored by the SMEs on the second day of on-site focus group meetings [24]. To capture the physical arduousness and mission criticality of the PPTs, each physical task for frequency and each physical subtask for repetition, duration, intensity (physical), and importance (critical to mission success) [2 , 19] were scored by the SMEs. The SMEs scored tasks and subtasks per operational missions conducted over the past seven years and in the context of their MOS-specific duties (operations/missions/shifts), see Table 3.

Table 3
Likert scale for independent scoring of physical tasks and subtasks

Score 1 2 3 4 5

Task Frequency Never performed^* Rarely Sometimes Often Always performed,

on every mission

Subtask Repetition N/A 1–5 / mission 6–8 / mission 9–12 / mission >12 / mission

Subtask Duration 0 secs–6 secs 6 secs–30 secs 30 secs–2 min 2 min–60 min >1 hour

Subtask Intensity^** 6, 7, 8, 9 10, 11, 12 13, 14, 15 16, 17, 18 19, 20

Subtask Importance Not Important Somewhat Important Important Very Important Crucial

Score	1	2	3	4	5
Subtask Repetition	N/A	1–5 / mission	6–8 / mission	9–12 / mission	>12 / mission
Subtask Duration	0 secs–6 secs	6 secs–30 secs	30 secs–2 min	2 min–60 min	>1 hour
Subtask Intensity^**	6, 7, 8, 9	10, 11, 12	13, 14, 15	16, 17, 18	19, 20
Subtask Importance	Not Important	Somewhat Important	Important	Very Important	Crucial

^*Trained, but never performed on a mission. ^**Converted from traditional 6–20 Borg rating of perceived exertion score to mathematical Likert equivalent 1–5.

A weighted equation (0.10 repetition + 0.25 duration + 0.25 intensity + 0.40 importance), that best captured the physical arduousness and mission criticality per the operations research experts’ analysis, was used to capture the composite score of each subtask. A priori thresholds [9] were used for component and composite scores: subtasks with duration ≥4.0, intensity ≥3.5, importance ≥3.5 or a composite score ≥3.5 points on the 5.0 point Likert scale were scored as “met criteria” for final confirmation. For SME review and confirmation in the next stage (Focus Group Day Three), meeting/not-meeting criteria data and inter-member variance data were compiled by the AF Exercise Science Unit. The a priori thresholds listed above were assessed to determine “did not meet criteria” and “met criteria” status for each subtask. A score of 2.0 on the Likert scale was the threshold used for inter-member variance, agreement occurred with variance ≤2.0, disagreement >2.0.

3.3.4 Stage 4: Focus group day three

Subtasks were confirmed, physical descriptors assigned, and conditions clarified by the SMEs on the final day of the on-site focus group meeting. Focus group members were guided by the AF Exercise Science Unit facilitators to reach group consensus on the following:

Subtasks not meeting the physically demanding thresholds were revisited and confirmed by the focus group as physical and retained or non-physical and not retained for Sub-Step 1C

Subtasks that did not meet physically demanding criteria according to the physical component or composite scores, but were deemed critical by the importance score and follow on focus group consensus, were retained, e.g., security forces member very rarely perform cardiopulmonary resuscitation, however, it is physical and critical and therefore was retained

Subtasks were reviewed for redundancy, e.g., same movement pattern to accomplish similar subtasks; if redundant, similar subtasks were combined

Remaining subtasks that met a physically demanding threshold and were agreed upon by the focus group to be physically demanding, were identified as draft critical physical tasks (DPTs). For each confirmed DPT, the focus groups:

Confirmed where focus group agreement existed, inter-member variance ≤2.0

Discussed and reached consensus where focus group disagreement existed, inter-member variance > 2.0

Provided distance and mass data for DPTs including travel and load, respectively

Provided operational gear (kit) mandated for the DPTs (Table 4). Confirmed the exact set of gear or “kit” (Alpha through India in Table 4) that must be donned by all test subjects performing physical task simulations for methodological standardization in follow-on study steps (major steps two and three, field testing)

Confirmed physical methods/techniques members used to accomplish the DPT, e.g., drag, lift, carry

Addressed if there were operational limits on which physical methods/techniques one may use to accomplish the DPT, e.g., dragging equipment may cause mission failure (equipment damage)

Indicated if mechanical or technological advantages were present to alleviate human physical effort, e.g., climbing hoist

Indicated when DPTs were accomplished as a team vs individual and if mode was operationally required

Described conditions, e.g., weather, terrain, region, that could alter the DPT’s physical demand, conditions for a typical mission, noting that the task is not a condition. Also how pervasive were the conditions, across all missions? Facilitators encouraged focus group SMEs to avoid answering with “it depends”; rather facilitators pushed to obtain objective clarity

Assigned physical descriptors [25 –27] inTable 5. For each physical descriptor the SMEs indicated the extent to which the physical descriptor is used: minimally, moderate, great extent.

Identified the physical fitness components, per the American College of Sports Medicine Guidelines [28], required to perform the subtasks (Table 6)

Table 4
Operational gear or kit required for varied mission requirements

Kit Special Warfare Explosive Ordnance Disposal (EOD) Security Forces Fire and Emergency Services SERE

Alpha Miltiary Uniform + Helmet Miltiary Uniform Miltiary Uniform Miltiary Uniform Miltiary Uniform

Bravo Miltiary Uniform + Vest + Helmet Miltiary Uniform + Body Armor + Helmet Miltiary Uniform + Protective Vest Incident Specific Rescue Gear Miltiary Uniform + Ruck Sack

Charlie Miltiary Uniform + Vest + Helmet + Ruck Sack Miltiary Uniform + Combat Load (helmet, body armor, weapon) Miltiary Uniform + Plate Carrier Fire PPE w/out SCBA Miltiary Uniform + Vest + Helmet + Ruck Sack

Delta Miltiary Uniform + Vest (different load) Miltiary Uniform + Combat Load + Ruck Sack Miltiary Uniform + Plate Carrier + Helmet Fire PPE + SCBA (no mask) Miltiary Uniform + Vest + Helmet + Ruck Sack + Parachute System

Echo Miltiary Uniform + Vest + Ruck Sack (different loads) Miltiary Uniform + EOD Bomb Suit Miltiary Uniform + Plate Carrier + Helmet + Chemical Protective Gear Fire PPE + SCBA + mask Dry/Wet Suits + Helmet

Foxtrot Military Uniform T-shirt + Swim Trunks + Booties + Fins + Mask + Ruck Sack Miltiary Uniform + EOD Bomb Suit + SCBA Fire PPE + Chemical Protective Gear Miltiary Uniform + Cold Weather Gear + Ruck Sack

Golf Miltiary Uniform + Chemical Protective Gear HAZMAT

Hotel Miltiary Uniform + SCBA Wildland Fire Gear (no SCBA)

India Miltiary Uniform + Level A or B Protective Suit (HAZMAT)

Kit	Special Warfare	Explosive Ordnance Disposal (EOD)	Security Forces	Fire and Emergency Services	SERE
Alpha	Miltiary Uniform + Helmet	Miltiary Uniform	Miltiary Uniform	Miltiary Uniform	Miltiary Uniform
Bravo	Miltiary Uniform + Vest + Helmet	Miltiary Uniform + Body Armor + Helmet	Miltiary Uniform + Protective Vest	Incident Specific Rescue Gear	Miltiary Uniform + Ruck Sack
Charlie	Miltiary Uniform + Vest + Helmet + Ruck Sack	Miltiary Uniform + Combat Load (helmet, body armor, weapon)	Miltiary Uniform + Plate Carrier	Fire PPE w/out SCBA	Miltiary Uniform + Vest + Helmet + Ruck Sack
Delta	Miltiary Uniform + Vest (different load)	Miltiary Uniform + Combat Load + Ruck Sack	Miltiary Uniform + Plate Carrier + Helmet	Fire PPE + SCBA (no mask)	Miltiary Uniform + Vest + Helmet + Ruck Sack + Parachute System
Echo	Miltiary Uniform + Vest + Ruck Sack (different loads)	Miltiary Uniform + EOD Bomb Suit	Miltiary Uniform + Plate Carrier + Helmet + Chemical Protective Gear	Fire PPE + SCBA + mask	Dry/Wet Suits + Helmet
Foxtrot	Military Uniform T-shirt + Swim Trunks + Booties + Fins + Mask + Ruck Sack	Miltiary Uniform + EOD Bomb Suit + SCBA		Fire PPE + Chemical Protective Gear	Miltiary Uniform + Cold Weather Gear + Ruck Sack
Golf		Miltiary Uniform + Chemical Protective Gear		HAZMAT
Hotel		Miltiary Uniform + SCBA		Wildland Fire Gear (no SCBA)
India		Miltiary Uniform + Level A or B Protective Suit (HAZMAT)

SCBA, Self Contained Breathing Aparatus; HAZMAT, Hazardous Materials; PPE, Personal Protective Equipment. Spec War Delta and Echo configurations have different vest and ruck sack loads than Bravo and Charlie.

Table 5

Physical descriptors

Press/Push (Sagittal/Frontal Planes)	apply a physical force to move an object away from you
Pull (Sagittal/Frontal Planes)	apply a physical force to move an object towards yourself, or yourself towards an object
Bend (Sagittal/Frontal Planes)	flexion or bending of the hips, waist and spine
Core Rotation (Transverse Plane)	twist/rotation of the midsection
Squat (Sagittal Plane)	hip and knee flexion - move the hips back and bend the knees and hips to lower body mass and any accompanying weight, then return to upright position
Lift (Sagittal/Frontal Planes)	move an object upward with force
Velocity (Sagittal/Frontal Planes)
Walk	Walk <6.4 kph (4.0 mph) (one foot always in contact with ground)
Fast walk/Jog	Fast walk/Jog 6.4 kph (4.0 mph) - 9.7 kph (6.0 mph)
Run	Run >9.7 kph (6.0 mph)
Sprint	move your body as fast as you can in one direction
Power (Sagittal/Frontal/Transverse Planes)	apply a force per unit time, e.g., kicking in a door. Maximal power - maximal force per least amount of time
Agility (Sagittal/Frontal/Transverse Planes)	sudden start, stop and/or change in direction
Isometric Contraction	apply physical force equal to the resistive force with no movement, no visible change muscle length or body position, e.g., gripping equipment
Dynamic Balance	maintain body stability in an unstable environment while moving body, e.g., maintain stability while traveling over an uneven surface
Quickness / Reaction time (Sagittal/Frontal/Transverse Planes)	react to a stimulus and change body position at maximal rate, e.g., immediate action drills
Crawl (Sagittal Plane)	drag body along the ground in prone position using limbs and core strength / endurance
Climb	ascend or descend using limbs, hands and feet

Table 6

Physical fitness components

Health-related components of physical fitness
Cardiorespiratory Endurance	the ability of the circulatory and respiratory system to supply oxygen during sustained physical activity
Body Composition	the relative amounts of muscle, fat, bone, and other vital parts of the body
Muscular Strength	the ability of muscle to exert force
Muscular Endurance	the ability of muscle to continue to perform without fatigue
Skill-related components of physical fitness
Agility	the ability to change the position of the body in space with speed and accuracy
Balance	the maintenance of equilibrium while stationary or moving
Coordination	the ability to use the senses, such as sight and hearing, together with body parts in performing tasks smootly and accurately
Speed	the ability to perform a movement within a short period of time
Power	the ability or rate at which one can perform work
Reaction Time	the time elapsed between stimulation and the beginning of the reaction to it

Physical descriptor and physical fitness component data are essential for selection of physical fitness test component candidates in follow on major study step two. DPTs were merged from multiple focus groups by the AF Exercise Science Unit for each MOS and listed for scoring in the next sub-step.

3.4 Sub-step 1C - Assess MOS-specific airmen

To increase career field buy-in to the study process, provide quantitative data to supplement the focus group qualitative data, and to further refine the DPTs, MOS-specific Airmen across the AF (Special Warfare n = 614, Explosive Ordnance Disposal n = 781, Security Forces n = 1667; Fire and Emergency Services and Survival, Evasion, Resistance, and Escape studies paused at Sub-Step 1B) scored the DPTs for frequency, duration, intensity, and importance in a random ordered assessment via electronic web tool. Demographic information (years in MOS, number of deployments, skill level, rank, age) and DPT scoring data were provided by the Airmen through their answers to the following questions via drop down scales as in Tables 3 and 4 above:

Independently score each task from your current MOS for frequency, intensity, duration, and importance during your typical missions over the past seven years. Important: “typical missions” mean your physical actions during combat operations, operational deployments, or full mission profiles, but not during any other training outside of full mission profiles.

Frequency: please state how often you performed the task per mission. If you have never performed the task operationally, select N/A

Duration: please state how long it takes you to complete the task

Intensity: please state how intense (how hard) the physical effort is to complete the task (scale aid: multiply the scale value by 10 to approximate a heart rate intensity in beats/minute)

Importance: please state how important the task is to effective mission performance/success

Kit: please state the gear in which you have performed the task

3.5 Sub-step 1D - Observe operational tasks

This sub-step was conducted to refine and confirm DPTs via observational data gathered on DPTs performed in the operational setting. MOS incumbents at multiple locations (four to six military installations per MOS) performed DPTs during military operational mission scenarios for the AF Exercise Science Unit on-site team to observe, video record, and conduct notational analyses. MOS-specific DPT physical movements were recorded, and the notational analyses identified physical descriptors, metabolic demands, movement planes of motion, muscle action, peak intensity and environmental conditions per DPT. Additionally, where possible, DPTs were performed by AF Exercise Science Unit research team members for participatory experience and credibility.

3.6 Sub-step 1E - Interview leaders

In this final sub-step the DPT list was reviewed and confirmed by MOS-specific leaders - officers and senior non-commissioned officers experienced across all MOS mission sets (Table 2). During individual one-hour interviews conducted by AF Exercise Science Unit facilitators, the leaders (Special Warfare n = 31, Explosive Ordnance Disposal n = 10, Security Forces n = 11) reviewed DPTs for accuracy and breadth, and added input on present and future physical capabilities and environments. Leaders (interviewees) were provided the DPT list pre-interview. At the interview, leaders provided demographic data, and reviewed and discussed each DPT in detail by addressing the following questions:

Does this list represent what you expect your Airmen to be physically capable of performing?

What portion of your Airmen should retain the capability to perform the task?

What other physically-demanding tasks are missing from this list?

What other physically-demanding tasks should be added for future missions? You may focus on historical missions (operational or training) in which you participated to capture thoughts; however, apply to operational missions only

A re there any other factors (weather, terrain, external loads, equipment ... ) we should consider?

Other questions or comments?

Over the last seven years in the context of operational missions/duty shifts (in your MOS-specific mission sets), full unit operational training, operational deployments, or combat operations, and from after action reports, personal experience, observation of others, or verbally from another Airman (do not include basic, technical, or flight level training), please state:

the average and extreme times and ambulatory (walk, jog, run) distances for operations in various kits (leaders were provided a table listing gear, as Table 4 above)

a time and example, if possible, when the level of an Airman’s physical fitness either enhanced or hindered an operation

This final sub-step confirmed DPTs as the official Tier 2 occupationally specific, operationally relevant CPTs. All methodological sub-steps are depicted in Fig. 3. Descriptive statistics were calculated for Sub-Steps 1B, 1C, and 1E respondents, and for the physical task and subtask characteristics of frequency, duration, intensity, importance, and composite task score.

Fig. 3

AF Exercise Science Unit’s physical demands analysis sub-steps. Physical Tasks: Preliminary (PPT), Draft (DPT), Critical (CPT).

4 Results

4.1 Sub-Step 1A

Compilation of duty tasks from career field source documents in the first physical demands analysis sub-step resulted in hundreds of physical and non-physical duty tasks. These were subsequently narrowed to the first MOS-specific working list of physical tasks, the PPTs, described in lay terms with operational verbs and ranked by intensity. Number of duty tasks and number of PPTs are shown in the first two columns of Fig. 4, respectively.

Fig. 4

Delineation of duty tasks to critical physical tasks. Special Warfare: Special Tactics Officer (STO), Combat Control (CCT), Combat Rescue Officer (CRO), Pararescue (PJ), Tactical Air Control Party-Officer (TACP-O), Tactical Air Control Party (TACP), Special Operations Weather (SOWT). Explosive Ordnance Disposal (EOD), Security Forces (SF), Fire Emergency Services (FES), Survival, Evasion, Resistance, and Escape (SERE). Note: FES and SERE studies paused after Sub-Step 1B, CPTs pending resumption of follow-on sub-steps.

4.2 Sub-Steps 1B and 1C

Sub-Step 1B focus group SMEs and Sub-Step 1C scoring assessment Airmen provided qualitative and quantitative data, respectively, to identify and delineate physical tasks and eliminate redundancies. This resulted in the reduction and conversion of PPTs to DPTs (Fig. 4, columns 2 to 3). Demographic data in lines 1B and 1C of Table 7 portray the experience levels of the focus group SMEs and assessment Airmen, respectively.

Table 7
Demographic characteristics of 1B SMEs, 1C Airmen, 1E Leaders

MOS Sub - Step n Yrs in MOS Number Deployments Skill Level Rank Age

yrs 3-5-7-9 scale Range Low-High yrs

STO-CCT 1B 15 15±6 4±2 8±1 MSgt-Capt 39±3

1C 164 8±6 4±2 7±2 na na

CRO-PJ 1B 15 17±6 9±5 8±1 TSgt-Maj 40±6

1C 116 9±7 4±2 7±2 na na

TACPO- 1B 16 16±4 5±2 7±1 TSgt-Maj 36±3

TACP 1C 300 8±6 4±2 7±1 na na

SOWT 1B 12 12±5 6±2 7±2 TSgt-Maj 37±4

1C 21 12±6 5±3 7±1 na na

EOD 1B 17 9±5 3±2 7±1 SSgt-Capt 32±4

1C 781 8±6 4±2 6±1 na na

SF 1B 14 11±6 2±2 6±1 SSgt-Capt 33±4

1C 1667 9±6 na 6±2 Amn-Gen na

1E 11 17±4 4±2 8±1 MSgt-Lt Col 37±5

FES 1B 13 15±6 3±2 8±1 SSgt-SMSgt 36±6

MOS	Sub - Step	n	Yrs in MOS	Number Deployments	Skill Level	Rank	Age
				yrs		3-5-7-9 scale	Range Low-High	yrs
STO-CCT	1B	15	15±6	4±2	8±1	MSgt-Capt	39±3
	1C	164	8±6	4±2	7±2	na	na
CRO-PJ	1B	15	17±6	9±5	8±1	TSgt-Maj	40±6
	1C	116	9±7	4±2	7±2	na	na
TACPO-	1B	16	16±4	5±2	7±1	TSgt-Maj	36±3
TACP	1C	300	8±6	4±2	7±1	na	na
SOWT	1B	12	12±5	6±2	7±2	TSgt-Maj	37±4
	1C	21	12±6	5±3	7±1	na	na
EOD	1B	17	9±5	3±2	7±1	SSgt-Capt	32±4
	1C	781	8±6	4±2	6±1	na	na
SF	1B	14	11±6	2±2	6±1	SSgt-Capt	33±4
	1C	1667	9±6	na	6±2	Amn-Gen	na
	1E	11	17±4	4±2	8±1	MSgt-Lt Col	37±5
FES	1B	13	15±6	3±2	8±1	SSgt-SMSgt	36±6

Note 1: data in mean±standard deviation, except Rank in a low to high range. Note 2: skill levels are - 3 Apprentice, 5 Journeyman, 7 Craftsman, 9 Superintendent.

4.3 Sub-Step 1D

Focus groups also identified - and the 1D field observational sub-step reinforced the data - 14 physical descriptors, 10 physical fitness components (Tables 5 and 6, respectively), and the metabolic demands of CPT performance. Table 8 lists the percentage of one MOS’s (Security Forces) CPTs that require the respective physical attributes.

Table 8
Physical descriptor, metabolic demand, PF component data for one MOS, Security Forces

Physical Descriptors Iso Dyn Bal Vel Core Rot Quick / Rx Time Bend Squat Power Press / Push Agility Pull Lift Climb Crawl

93% 82% 71% 64% 61% 57% 57% 50% 43% 43% 39% 36% 29% 21%

Metabolic Demands 0 secs–6 secs 6 secs–30 secs 30 secs–2 mins 2 mins–60 mins >1 hour

25% 75%

Physical Fitness Components MS ME Bal Coord Power CRE BC Agility Speed Rx Time

100% 100% 88% 88% 88% 75% 75% 75% 63% 63%

Physical Descriptors	Iso	Dyn Bal	Vel	Core Rot	Quick / Rx Time	Bend	Squat	Power	Press / Push	Agility	Pull	Lift	Climb	Crawl
Metabolic Demands	0 secs–6 secs	6 secs–30 secs	30 secs–2 mins	2 mins–60 mins	>1 hour
			25%	75%
Physical Fitness Components	MS	ME	Bal	Coord	Power	CRE	BC	Agility	Speed	Rx Time
100%	100%	88%	88%	88%	75%	75%	75%	63%	63%

Iso, isometric contraction; Dyn Bal, dynamic balance; Vel, velocity; Core Rot, core rotation; Quick/Rx Time, quickness / reaction time; MS, muscular strength; ME, muscular endurance; Bal, balance; coord, coordination; CRE, cardiorespiratory endurance; BC, body composition; Rx Time, reaction time.

4.4 Sub-Step 1E

The last sub-step, interviews with leaders, confirmed DPTs to the final official Tier 2 occupationally specific, operationally relevant CPTs as seen in the latter two columns of Fig. 4. Demographic data for one MOS, Security Forces, are listed in Table 7 in line 1E. Samples of CPTs are listed within one sample mission set per MOS in Table 9 (no CPT data for Fire and Emergency Services and Survival, Evasion, Resistance, and Escape, paused at Sub-Step 1B). All MOS-specific mission sets, each containing one or more CPT(s), are listed in Table 2.

5 Discussion

5.1 Purpose / Study design

The second “Tier” of the AF Exercise Science Unit’s approach to developing physical fitness tests, standards, and physical training guidance encompasses multiple steps. This study addressed the first step in this Tier 2 occupationally specific, operationally-relevant process. Step 1, as the Fig. 2 pyramid illustrates, is foundational to the overall process [10 , 29]. Hardison, et al. [11] state that this first major step in the Tier 2 occupationally specific, operationally-relevant process must be “complete, accurate and sufficiently detailed to support the remaining steps in the standard-setting process.” Therefore, we employed five comprehensive sub-steps with overlapping scoring and subjective and objective cross checks to conduct a thorough physical demands analysis to identify and delineate occupationally specific, operationally relevant critical physical tasks for eight AF physically demanding occupations.

Table 9
MOS-specific critical physical task samples within one of multiple mission sets

Special Tactics Officer / Combat Controller

Landing Zone Operations

Perform contingency ammo resupply

(context: engine-running loadings/unloadings of aircraft or infil/exfil)

Loading/unloading equipment on/off aircraft

(context: engine-running loadings/unloadings of aircraft or infil/exfil)

Clear and move through vegetation

(context: jungle operations)

Combat Rescue Officer / Pararescue

Casualty Collection

Drag casualty over adverse terrain without litter

(context: move casualties over adverse terrain to cover (without litters))

Carry casualty over adverse terrain without litter

(context: move casualties over adverse terrain to cover (without litters))

Establish a lift position and raise or lower litter from ground to above head

(context: maneuver litter over adverse terrain)

Tactical Air Control Party Officer / Tactical Air Control Party

Small Unit Tactics

Execute posture transitions - prone to kneeling to standing

(context: perform individual movement techniques)

React to direct/indirect fire, react to far/near ambush

(context: conduct dismounted operations)

React to enemy contact/break contact

(context: conduct dismounted operations)

Special Operations Weather

Prepare Deployed Location

Haul/carry luggage, ruck, equipment

(context: pack/palletize deployment/contingency equipment on/off aircraft)

Assemble antenna (Tactical Meteorological Observation System)

(context: set-up/tear down electronic equipment)

Clear/remove debris or obstructions

(context: drop/landing zone activities)

Explosive Ordnance Disposal

Locate, Identify, Render Safe Explosive Ordnance

Traverse terrain while sweeping with mine detector

(context: locate, identify, and render safe booby traps/IEDs/conventional munitions/fuses)

Transport equipment, tools, munitions, and fuses through adverse terrain

(context: locate, identify, and render safe booby traps/IEDs/conventional munitions/fuses)

Position and stack munitions for detonation

(context: locate, identify, and render safe booby traps/IEDs/conventional munitions/fuses)

Security Forces

Law Enforcement Subject Control Techniques

Use less than lethal force to gain compliance

(context: use baton for subject control techniques)

Detain/apprehend subject; search and handcuff subject if necessary

(context: control subject during detainment and movement)

Employ Security Forces combative skills

(context: perform combatives - defensive hand to hand)

5.2 Physical demands analysis

In a description of Step 1 of the overall six-step process, Stevenson et al. [15] and Payne and Harvey [18] delineate between job task analysis and physical demands analysis, the former identifies CPTs whereas the latter quantifies the physical demands of the identified tasks. Rayson [10], citing the context of occupational physical fitness with focus on the physical, rather than psychosocial demands of jobs, states that physical demands analysis is a more appropriate term here. Accordingly, we broadly apply the physical demands analysis term, our analysis both identified CPTs and quantified the physical demands of said CPTs.

5.3 Sub-Step 1A

The results of this study demonstrate that the five sub-step process employed was successful for systematically identifying and describing CPTs performed by Airmen in eight different US Air Force MOSs. Sub-Step 1A grossly reduced (Fig. 4 columns 1 to 2) duty tasks to PPTs, by eliminating non-physical tasks, broadly describing PPTs in lay terms and ranking the PPTs. Sub-Step 1A also set the precedent for significant MOS-specific SME involvement [10 , 29] throughout the entire Tier 2 occupationally specific, operationally relevant process to include the four subsequent sub-steps in Step 1.

5.4 Sub-Step 1B

The bulk of the overall Step 1 refining effort was accomplished in Sub-Step 1B through the four-staged focus groups. SME independent [24] scoring produced qualitative physical (frequency, duration, intensity) and criticality (importance) data, highlighting the first and third stages. Each of these stages were followed with consensus building stages. Using a prepared script for standardization [24], trained facilitators guided SMEs, armed with scoring data, to group consensus on conversion of PPTs to DPTs. Accounting for and working through inter-member variance with the SMEs was representative of the redundancy checks in this sub-step. Conducting three separate four-stage focus groups per MOS (two for Survival, Evasion, Resistance, and Escape) with separate sets of SMEs further strengthened the study. Finally, focus group SMEs provided details and conditions to attenuate the variability across multiple factors, e.g., distances, loads, gear, technology [16, 17], that can influence occupational performance outcomes [30] and are critical to the remainder of the overall study process. The scoring equation we used to rank CPTs weights the criticality factor heaviest. These scores of importance are based on serious outcomes where failure to perform the task may result in major loss, e.g., injury, death, mission failure [24] no matter the frequency, duration, or intensity scores of the task. Also, the higher weighted import score places appropriate emphasis towards an increased focus in training MOS members on these high-import tasks [31].

5.5 Sub-Step 1C

Sub-Step 1C’s quantitative data from MOS-specific Airmen across the AF, reinforced the 1B qualitative data providing strong breadth and depth, respectively, to the scoring of physical tasks. This reduced and quantified the physical tasks to the near-final DPT list (Fig. 4, columns 2 to 3), manageable and prioritized for field observations. Potential order effects were attenuated in Sub-Steps 1B and 1C with randomization of PPT mission sets and DPT lists prior to respective scoring.

5.6 Sub-Step 1D

Sub-Step 1D brought objectivity to the otherwise subjective physical demands analysis process [16, 24]. Field observations of DPTs, video recordings, checklist driven needs analyses [16] including direct interaction with incumbents and SMEs performing the DPTs, provided tangible reality to the process. A visual data record of physical requirements, e.g., the movement patterns necessary to perform tasks, importantly help frame the final CPT quantification, and identify the percent CPTs requiring the physical attributes listed in Table 8. These physical descriptor, metabolic demand, and physical fitness component data figure prominently in follow-on research study steps, such as developing physical task simulations and selecting physical fitness test candidates. Finally, Sub-Step 1D’s research team – career field customer direct interaction provided face validity to the process, and research team members performing CPTs enhanced credibility and improved the research team’s understanding of the physical demands under scrutiny [16].

5.7 Sub-Step 1E

Senior SME leader (senior non-commissioned officers and commissioned officers from varied commands) confirmation of the CPTs (Fig. 4 columns 3 to 4) in Sub-Step 1E was the final sub-step in this initial study providing the critical foundation for the remaining steps in the overall Tier 2 occupationally specific, operationally relevant process. Table 9 lists samples of MOS-specific CPTs in context by mission set. Some physical employment standards research may not account for CPT context, sequencing, or integration that may occur on operational missions [32, 33]. However, we performed CPTs individually and in aggregated mission set sequences for further understanding, to best determine physical demand, and as a basis for physical task simulation development [33].

5.8 Subject matter experts

Level of experience - time in MOS, time deployed, time in service - affects physical task performance [34]; these same experiential criteria are important for MOS SMEs as addressed by Milligan et al. [29] to include performing, directing, training, witnessing, and leading physical tasks. We employed SMEs across the sub-steps, SMEs of varied experience as portrayed by years in MOS, number of deployments, varied skill levels and roles, rank, and age in Table 7. Multiple, expert SMEs with relevant, current technical knowledge [29] from across all MOS mission sets worked in multiple focus groups (lines 1B in Table 7). Large samples of Airmen from various ranks (airman to general officer) and with recent experience [15] provided valuable score data in Sub-Step 1C. In Sub-Steps 1A, 1B, 1D, and 1E our research team had direct interaction with SMEs stressing the import of research team and SMEs working together [6, 31] to select CPTs. Special Warfare career fields had recently opened to females, so they did not have females in operational roles, but Explosive Ordnance Disposal, Security Forces, and Fire and Emergency Services were represented by SME females greater than their incumbent percentages (females in 1B: Explosive Ordnance Disposal 17.7% , Security Forces 21.4% , and Fire and Emergency Services 7.7% ). Also in Table 7, demographic data in line 1E under Security Forces show the broad and deep experience of senior leader SMEs who independently [24] reviewed and confirmed CPTs. Our SME arrangement included incumbents performing physical tasks; supervisors performing, leading, training; supervisors not performing but leading [35], senior leaders reviewing and overseeing, multiple groups in Sub-Step 1B, and multiple locations in Sub-Step 1D. This SME arrangement exceeded the Milligan et al. [29] recommendation for SMEs to meet at least two of nine criteria for identifying SMEs for military tasks. Several of our SMEs and all our SME groups met nine of nine criteria. These experientially broad and deep SMEs in groups where the “sum was greater than the parts” enhanced the comprehensive process, avoided lower quality products, and avoided bias that may occur in physical employment standards development with:

limited number of SMEs [33]

a narrow range of SMEs [36]

limited range of roles and experience [15 , 35]

levels of experience [24, 33] -Table 7 data show we surpassed these recommendations

5.9 Comprehensive

It appears a few other studies [2 , 14] apply or recommend [10, 11] a similar methodology, using three to five sub-steps to determine CPTs, as our five sub-step comprehensive approach. However, several [8 , 37–41] other studies undertook only one or two sub-steps. Our five sub-steps are in accordance with the Constable and Palmer [1] recommendations and meet eight of the nine techniques listed by Nevola et al. [42]; the only technique we did not address is case law as this does not apply in the US Air Force for standards development.

5.10 Limitations

Although our study included objective observations and data collection in Sub-Step 1D, and clear mathematical scoring parameters in the first three sub-steps, subjectivity remains in the majority of the sub-steps and may be a source of unaccounted variance. Specifically in Sub-Step 1D we could have added objective physiological monitoring of physical subtasks; however, this omission did not prevent selection of optimal predictive physical fitness tests (later manuscripts). Tier 2 occupationally specific, operationally relevant tests, standards and training are gender-neutral by design and requirement; therefore, the lack of experienced female SMEs in the Special Warfare and Survival, Evasion, Resistance, and Escape career fields should not be a hindrance but may be a face validity issue. Finally, our findings stem from a US Air Force population and requirements and therefore may not be generalizable to other military or civilian populations.

5.11 Summary

We hypothesized that a multiple sub-step methodology would provide clear CPT data that career field leadership would confirm and approve for follow on Tier 2 occupationally specific, operationally relevant process work. The present study is arguably one of the few military studies to encompass five comprehensiveness sub-steps to select CPTs. We achieved comprehensiveness and thoroughness via multiple sub-steps, three focus groups per MOS, inter-member variance accounting, CPT integration within mission set context, and use of multiple experientially deep and broad ranging MOS-specific SMEs. This provided our career field customers confidence in the main study finding: our research team employed five comprehensive sub-steps with overlapping scoring and subjective and objective cross checks to conduct a thorough physical demands analysis to identify, delineate, and describe occupationally specific, operationally relevant critical physical tasks for eight AF physically demanding occupations. This reduction of duty tasks to well defined CPTs is the underpinning for follow-on development of physical task simulations, physical fitness test candidates, and physical training guidance - important to avoid the Air Force’s test-centrism in PF. The Step 1 physical demands analysis process should be reviewed on a routine basis to account for mission set changes, technological advances and equipment and load changes that may increase or decrease physical and physiological burden [6, 8]. Lastly, this effort is a major step towards establishing a Tier 2 occupationally specific, operationally relevant science basis in the US Air Force PF Program in accordance with US public law requirements. No documentation, only anecdotal evidence, i.e., “the test has stood the test of time,” exists for the majority AF PF program history and for all current tests and standards across AF training and operations. Our operational requirements-based physical demands analysis that identified and quantified CPTs is a start down the road to overcome institutional resistance steeped with traditional-historical normative, arbitrary military PF tests, standards, and training guidance.

6 Conclusion

The study approach proved efficacious for conducting a thorough physical demands analysis to identify, delineate, and describe occupationally specific, operationally relevant critical physical tasks for eight AF physically demanding occupations. The physical demands analysis process here, Step 1 of the overall six step process, increased engagement and provided buy-in across occupations queried, as acknowledged by members and leaders identifying the process as conclusive. Importantly, resulting CPTs provide the basis for the next major step in the overall research process, developing physical task simulations to link to predictive physical fitness test batteries and physical training guidance.

Acronyms

AF Air Force

CPT critical physical task

DPT draft critical physical task

MOS military occupational specialty

PF physical fitness

PPT preliminary physical task

SME subject matter expert

Footnotes

Acknowledgments

The authors thank Jordan Becker, Mark Docken, Elizabeth Kilby, Justin Cupples, and Ryan Logan for their exceptional research assistance; Alaina Dooley, Sarah Casey, and Sara Juback for their focus group and analytical expertise; and Ms Doris Perez for her consistently first-rate library and literature support.

Ethical approval

Approval was obtained from the US Air Force 59th Medical Wing Institutional Review Board; approved protocol numbers and dates: Battlefield Airmen (Special Warfare) FWH20150006H - 25 Nov 2014, Explosive Ordnance Disposal FWH20170109H - 1 Jun 2018, Security Forces FWH20210104H - 22 Jun 2021.

Informed consent

Focus group participants provided written informed consent before participation.

Conflict of interest

The authors declare they have no conflict of interest.

Funding

The research was supported in part by US Headquarters Air Force funding.

Disclaimer

The views expressed in this presentation are those of the authors, and do not necessarily reflect official U.S. Government, Department of Defense, or US Air Force positions or policies.

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Score	1	2	3	4	5
Task Frequency	Never performed^*	Rarely	Sometimes	Often	Always performed,
					on every mission
Subtask Repetition	N/A	1–5 / mission	6–8 / mission	9–12 / mission	>12 / mission
Subtask Duration	0 secs–6 secs	6 secs–30 secs	30 secs–2 min	2 min–60 min	>1 hour
Subtask Intensity^**	6, 7, 8, 9	10, 11, 12	13, 14, 15	16, 17, 18	19, 20
Subtask Importance	Not Important	Somewhat Important	Important	Very Important	Crucial