The medical response to a major incident is a chain of many components: Prehospital response, transport, hospital response, communication, coordination and command. The outcome of a response is is dependent of the function of all these components, and also (which is important) how they function together. Consequently, effective and realistic training cannot be done by training of one isolated component: The different functions must be trained together to make possible an accurate evaluation of the outcome, as a base for further development of methodology.

A way to achieve this is to use advanced simulation models. In such models, special emphasis can be put on any of the components in the chain, but all the other components also have to be involved to permit a complete and realistic training, and also an accurate evaluation of the outcome with regard to mortality and complications.

The over-all aims of the MRMI-course are to:

1. Teach and train a methodology that can be used to achieve these goals
2. Train medical staff on different positions together in decision making and performance in major incidents

The course includes three full days of training and is built up in two steps:

1. Introductory lectures and practical training sessions in groups under guidance of instructors
2. Two consecutive full scale simulation exercises, where the whole response to a major incident is trained with supervision and evaluation by instructors. All delegates are actively working in their respective functions. 

The simulation system used in the courses is the MACSIM® system (www.macsim.se ).