U.S. Army Reserve 1st Lt. John Gotta, a South Kingstown, Rhode Island native and emergency room nurse with the 399th Combat Support Hospital, 804th Medical Brigade, 3d Medical Command (Deployment Support) makes sure it is clear before delivering a shock to a simulated casualty during an exercise held April 2, 2016 at the Mayo Clinic Multidisciplinary Simulation Center in Rochester, Minnesota. The purpose of the exercise was for the 399th CSH Soldiers to practice the Department of the Defense mandated framework known as Team Strategies and Tools to Enhance Performance and Patient Safety, or TeamSTEPPS. TeamSTEPPS optimizes military medical care by focusing on reducing communication errors that can lead to improper patient care.