Background According to the statistics of the National Labour Inspectorate, an alarming number of deaths and serious fire accidents have taken place during the past 10 years in the health care institutions in Estonia. There is a special legislative act for insuring fire safety in these institutions, but it has proven to be insufficient. Each hospital and nursing home has to ensure their own safety. Therefore, the Fire Safety Training course has been implemented in Tallinn Health Care College for the future personnel of medical institutions as a method of raising awareness. It consists of an introductory training for future hospital employees and annual trainings held by hospitals. The introductory portion of the programme lies in simulation training and E-learning.

The aim of this study is to assess the effectiveness of the learning programme.

Material and methods The course is located in an online environment in which every employee goes through a number of topics followed by a test. Everyone who passes the test can print out a certificate as a confirmation of the theoretical knowledge acquired throughout the course. This programme was first used in 2014. The practical portion of the programme takes place at Tallinn Health Care College’s simulation centre and includes patient evacuation practice, fire extinguishing simulations etc.

The effectiveness of the learning package was examined by comparing the results of different approaches on the programme with the participation of 70 nurses, that had undergone the usual fire safety training for 2 hours in their workplaces. The nurses were divided into 2 equal groups (35 people). The training took place for two days.

The first group began with a 2-hour lecture, followed by individual training in the E-learning environment and the simulation portion of the programme.

The second group began with a 2–hour lecture, directly followed by simulation, leaving individual training portion in the E-learning environment for last. In the first phase of the simulation portion it was necessary to extinguish a fire, the second was to ensure the proper evacuation of the patients. All of the action was filmed. The training ended with discussions, analysis and evaluating the activities recorded on video.

Results The results were better in the group that passed the E-learning course before entering simulation training, than for those who began their course with simulation training.

The students got the possibility to analyse important problems that may arise in real-life work situations.

Conclusions It is necessary to use the advanced training methods to decrease the number of fire related accidents and human losses.