In this episode of Between 2 Simulators, Philip Lex, Head of Medical Training at ADAC HEMS Academy, shares his journey from ground paramedic to HEMS instructor and medical training leader. Philip discusses the unique challenges of HEMS simulation, including the importance of CRM, teamwork, and ad hoc collaboration with unfamiliar emergency crews. He emphasizes the need for standardization in simulation training to improve quality and highlights ADAC’s innovative use of incident reporting systems to refine training scenarios. Philip also underscores the value of multi-agency training and encourages global collaboration to improve air rescue systems worldwide.
In this episode of Between 2 Simulators, Philip Lex, Head of Medical Training at ADAC HEMS Academy, shared his remarkable journey from paramedic to training leader in one of Germany’s largest air rescue organizations. Speaking with host Jake Rahman at IMSH 2025, Philip explored his career path, the complexities of training Helicopter Emergency Medical Services (HEMS) crews, and his views on simulation standardization.
Philip’s insights reveal the unique challenges of preparing medical teams to deliver life-saving care in unpredictable, high-pressure environments — with simulation playing a critical role in ensuring success.
From Ground Paramedic to Air Rescue Expert
Philip’s career began with over 20 years as a ground paramedic in Germany’s emergency medical system. While his early years were spent responding to traditional ambulance calls, Philip’s career took a significant leap when he transitioned to air rescue.
“Becoming a flight paramedic was always a dream,” Philip explained. “But it’s incredibly difficult to land a position in air rescue. It’s not just about skills — you need to be in the right place at the right time.”
Philip’s experience in education played a key role in securing his place. As a Bachelor of Education in Medical Science, he became responsible for training paramedic trainees in Munich for the Red Cross before advancing to the ADAC HEMS Academy — a prestigious institution affiliated with Germany’s largest air rescue operator.
- Today, Philip juggles three roles:
- Training Coordinator — overseeing medical education for HEMS crews.
- Instructor — delivering hands-on training to paramedics and doctors.
- Active Flight Paramedic — working shifts aboard ADAC’s air rescue helicopters.
“It’s truly my dream job,” Philip said. “I get to combine education, administration, and operational work — it’s a perfect mix.”
The Challenges of HEMS Simulation Training
Training for helicopter emergency medicine is vastly different from traditional clinical education. HEMS teams face unpredictable scenarios that demand fast thinking, clear communication, and precise teamwork.
“In a hospital, you’re in a controlled environment,” Philip explained. “In HEMS, you never know what scene you’re flying into. Every mission is different — and that’s what makes training so complex.”
Key challenges in HEMS simulation include:
- Technical Complexity — Training requires specialized equipment, including simulation helicopters that mimic the confined, noisy, and turbulent environment of real aircraft.
- Multi-Disciplinary Teams — HEMS crews typically consist of a pilot, doctor, and paramedic, requiring high-level Crew Resource Management (CRM) skills to ensure clear communication and effective teamwork.
- Ad Hoc Teams — Often, HEMS crews arrive at scenes where they must collaborate with unfamiliar ground paramedics or firefighters, making improvisation and role clarity critical.
“Our training focuses heavily on CRM because effective teamwork is vital,” Philip noted. “It’s not just about the medicine — it’s about managing resources and making smart decisions under pressure.”
How Simulation Enhances HEMS Preparedness
Philip emphasized that simulation’s greatest strength is preparing crews for unexpected challenges. While medical skills are fundamental, HEMS teams must also develop the foresight to anticipate potential complications during transport.
“In an ambulance, you can stop, re-evaluate, and act,” Philip explained. “In a helicopter, once you’re in the air, your options are limited. You have to plan ahead.”
To improve this foresight, ADAC HEMS Academy integrates scenario-based training that mirrors real-world complexities. Simulation exercises place crews in challenging conditions — from mountain rescues to accidents in remote regions — forcing them to make rapid decisions while juggling multiple roles.
Learning from Incidents: The Power of Reflection
One of the most valuable outcomes of simulation training at ADAC HEMS Academy comes from their incident reporting system. This system encourages crews to submit reports about incidents, close calls, or unusual situations encountered during missions.
“We collect this data and use it to design future training scenarios,” Philip explained. “If an incident reveals a weakness in our processes, we build that challenge into our simulations to better prepare our teams.”
This feedback loop ensures training remains relevant, adaptive, and focused on real-world challenges.
Standardization in Simulation: A Necessary Evolution
When asked about the role of standardization in healthcare simulation, Philip was clear — the industry needs clearer guidelines.
“We all know there’s good training and bad training,” Philip said. “Just mandating ‘50 hours of simulation per year’ doesn’t guarantee quality. We need standards that focus on outcomes, not just hours spent in training.”
Philip advocates for developing clearer frameworks that define the quality of training, instructor qualifications, and effective delivery methods. He believes that focusing on outcome-driven training will ultimately improve patient care.
“It’s not about how many hours you train — it’s about ensuring that every hour is meaningful.”
Collaborating Across Borders for Better HEMS Training
Given the differences in healthcare systems worldwide, Philip stressed the importance of sharing best practices across countries.
In Germany, HEMS is state-funded, operating with doctors on board and strict two-minute response times. Meanwhile, in countries like the UK, HEMS organizations rely heavily on charitable funding and often operate without dedicated onboard doctors.
“HEMS varies dramatically from country to country,” Philip explained. “But while the systems may differ, the core principles of teamwork, resource management, and clinical decision-making are universal.”
To promote cross-border collaboration, ADAC HEMS Academy participates in AirMed, an international air rescue congress held every five years. The next event — hosted by ADAC in Munich in 2026 — aims to foster global knowledge exchange for air rescue professionals.
Multi-Agency Training and Preparedness
Philip emphasized the growing need for multi-agency collaboration in training. Emergency situations often require coordination between HEMS teams, police, firefighters, and ground paramedics.
During the COVID-19 pandemic, ADAC HEMS Academy trained Germany’s state police helicopter crews to assist with potential COVID patient transfers — ensuring crews were equipped to work alongside paramedics if needed.
“Thankfully, they never had to put that training into action,” Philip said. “But they were ready — and that’s what matters most.”
Final Thoughts: A Passion for Learning and Saving Lives
Philip’s career is a testament to the power of continuous learning, adaptability, and a commitment to improving patient outcomes through effective training.
“Simulation doesn’t just teach medical skills — it builds confidence, sharpens decision-making, and empowers teams to manage chaotic situations,” Philip concluded.
With his dedication to developing comprehensive HEMS training, Philip continues to leave a lasting impact — not just in Germany but in air rescue systems worldwide.
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