Pilots, given initial training in flight simulators, tend to crash them over and over again.
Niiiaaaaoow. . . bang! One minute airborne, the next dropping out of the sky. Around 70 trainee NHS managers know the feeling well.
They took part last week in HSJ's first ever Future Leaders Challenge, a one-day simulation, run with Birmingham University's health services management centre. It was designed to test strategic planning and partnership working - but some participants will have experienced a little turbulence.
Assembled together in teams which met for the first time the evening before, the NHS management training scheme members took on the roles of health authorities, primary care trusts, community and mental health trusts, acute trusts and city councils.
Perhaps a tad cruelly, the trainees from the 1998 and 1999 intakes were thrown into a maelstrom similar to that presented to fully fledged health service managers in the HSJ Management Challenge earlier this year.
Forced to wrestle with the kind of£15m deficits they have not yet had a chance to run up in real life, the junior managers set out their strategies for the local health economy and planned service reconfigurations and joint bids for health action zone funds.
Obviously the discovery of a paedophile working in a children's home, allegations of racism against senior consultants and the attention of the media didn't always help. But never mind, those friendly supportive types you get at the regional office - roleplayed with some relish by three real life NHS chief executives - were always on hand. How reassuring.
The 'regional officers', who also assessed the teams' performance, were impressed. Assessor Nick Wood, real life chief executive of East Cheshire trust, said: 'The thing that mainly struck me was the enthusiasm and commitment of the participants.'
Another assessor, Munro Donald, chief executive of Bassetlaw Hospital and Community Services trust, added: 'I thought they were incredibly competent.
They showed lots of skills that suggest the future of health service management is extremely bright.'
Two, perhaps contradictory, qualities also showed themselves. One was what assessor Jeanne Hardacre from HSMC called 'values-driven behaviour'.
A team playing a community and mental health trust worked towards dissolving itself - in order to provide the service more appropriately elsewhere.
'As long as it was an improvement for the services they provided, the fact they no longer existed didn't matter to them, ' said Mr Wood.
'They were totally values-driven - as a board they'd be out of a job in 12 months, 'Ms Hardacre pointed out.
The other quality was easily spotted amid all the partnership and co-operation on show - bitter rivalry. 'I was surprised by the competitive spirit, ' said Mr Donald.
The studious faces clustered round tables in Birmingham's Clarendon Suites hardly suggested an outward bound course - but the teams looked to a huge range of outside organisations 'for information, to seek collaborative and partnership arrangements, to inform and to try to smooth the waters, ' said Sue Balderson of De Montfort University, who was an assessor.
She had to pose, in turn, as: 'a PCG, the community health council, the British Medical Association, the Royal College of Surgeons, a GP, the MP, a voluntary body, the neighbouring HA, the chamber of commerce, a local company, a housing association, the local medical committee, a Bangladeshi users' group, a regional nurse - and the European Union.' But the trainees felt the trials and tribulations gave the most food for thought.
'For the last hour to be worth it, the first four hours have to be purgatory, ' said Martin Wilson from Northern and Yorkshire region.
'The thing was, we had to make the plans. In our usual jobs we get direction, ' said Triona Buckley from the North West.
'I'm not sure we'd have got as much out of the experience if it all went well.'
Iain Mellis of South West region found it 'very intense', but 'there was a lot to reflect on'.
There were tensions, some tears and a stormy vote of no confidence, but it was clear the participants had learned a lot.
Professor Rod Griffiths, West Midlands regional director of public health, who presented awards to teams which performed particularly well, pointed out that being able to make mistakes in safety was a good way to learn.
'Pilots can get very upset when they crash a simulator - but they don't get killed, ' he said. The surviving trainee managers laughed a little queasily.
HSJ Future Leaders challenge award winners Outstanding achievement Joe Rafferty, Karen Taylor, Jenny Dunning, Kathryn Lea, Alison Wynne .
Teamwork Emma Richards, Kathryn Caley, Emma Clarke, Alison Hardacre, Rebecca Larder.
Creativity Jane Raymond, Levi Buckley, Jane Poulter, Catherine Seymour, Karen Martin.
Communication and presentation Justine Rawlings, Paul Birch, Susan Long, Richard Wells.