An introduction to macrosimulation and Hospex

The Hospital Exercise (Hospex) is the pre-deployment training programme used by the UK Defence Medical Services. It is one of only a handful of examples of macrosimulation existing worldwide. Hospex is innovative and engaging, and with the ever-growing evidence base supporting the use of simulation as a teaching tool, it is undoubtedly an invaluable resource from which other organisations could learn.

This article aims to: introduce macrosimulation as a learning technique; present Hospex, one example of the ambitious ways in which simulation can be used; and present some of the evidence in support of simulation.

Field hospital training has existed for decades. However 'early variants lacked realistic clinical input and had little relevance to the needs of the deploying field hospital' [Col. K Gill Late (L), Royal Army Medical Corps Volunteer (V); personal communication]. With war in Iraq and Afghanistan, planners recognised the need for a realistic and relevant training model. This was the beginning of Hospex. Hospex in its current form involves the complete and realistic simulation of an entire field hospital, in which staff work through real-life scenarios in real time.

Evidence supporting the value of simulation as a teaching tool is ever growing. It is a transferrable resource that could be adapted to fit many briefs, including civilian health care training programmes.