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Background. Acute posttraumatic pain relief in the pre-hospital setting still proves ineffective. Despite indications opioid drugs are too rarely administered, mainly due to insufficient knowledge concerning their use as well as anxiety about presence of opioid-related side effects. The aim of the present study was to compare the influence of two different techniques of training on the efficacy of acute pain relief therapy in different emergency scenarios in medical simulation. Material and methods. 100 teams consisting of fifth year medical students were randomly allocated into two groups receiving either simulative (S group) or classical method (group K) of medical training. In order to assess the efficiency of pain relief-directed therapy the teams of students aimed to implement pain relief-directed therapy of acute post-traumatic pain in different simulative scenarios. A cumulative dose of either 200 micrograms of fentanyl or 12 miligrams of morphine was assumed to produce pain relief (pain intensity under 5 points in numeric rating scale - NRS). Results. 46 teams from group K and 48 teams from group S were included into final statistical analysis. In the groups of teams from S group we found statistically significant difference in higher rate of identification of acute pain using numeric rating scale, increased efficacy of pain-relief directed therapy using opioids, reduction of opioid-related side effects compared to K group. Conclusions. Medical training using simulative method leads to statistically significant improvement in frequency of detection of acute pain intensity using numeric rating scale (NRS), increased effectiveness of pain relief-directed therapy with opioids, reduction of the rate of opioid-related side effects, improvement of educational effects of performance during emergency situations of fifth year medical students during medical simulation trauma scenarios as compared to classical method of medical training. [ABSTRACT FROM AUTHOR]