The British Battlefield Advanced Trauma Life Support (BATLS) course had been an essential part of the pre-mission training for almost a decade, when full-fledged simulations were integrated with the course in 2006. Earlier the centre made use of the more basic manikins, but the instructors are experiencing that the advanced simulators are enhancing the training as these simulators make it much easier to portray real life situations and to perform team training.


Running the simulation scenarios 

Training in the simulation lab.

The alerted team is given the context of an immediate incident and then introduced to the simulator that will be acting as their patient during the upcoming scenario. The instructor is located in the control room, adjacent to the simulation lab. From here, the instructor is able to dynamically control the simulator's vital and physical signs and tailor the level of difficulty according to how the scenario plays out in the next room. A microphone placed inside the manikin allows the instructor to give the patient simulator a voice, and the one-way mirror to observe the ongoing action.



The simulation scenarios are all videotaped and applied during subsequent structured debriefings where discussions of what went well and what could be improved upon occur in a nonjudgmental fashion.


Military personnel training tactical field care.

Evaluation of the training method

In order to evaluate simulation as a method for military medical training, a total of 117 consecutive participants (doctors, nurses and medics) taking part in a Swedish BATLS course were presented with a questionnaire comprising the following statements:

  • Simulation training gave me an experience of realism
  • Simulation training has increased my trauma life support skills
  • Audio-visual effects generated during the scenario increased my experience of realism
  • Simulation training has increased my ability to give a positive contribution to the team performance



A ‘positive response’ was defined as ≥4 on a 5-point Likert scale. All 117 participants responded to the questionnaire and the corresponding percentage of positive responses varied from 71.8 - 94.0%.  



Simulation training is becoming increasingly popular for training of non-technical team skills. When using the simulator lab, it is quite easy to create complex scenarios by combining medical challenges with issues concerning command and control, safety and communications. The new wireless simulators make it easier to extend the use of the simulators and perform in situ training outdoors and inside vehicles.