A first aid competition team comprised of five Ambulance Members gathered for a group photograph with the Dewar Shield

Early first aid competitions were basic, with simulated casualties having cards hung around their neck to tell competitors what their injuries were. Over the years, ingenuity and a desire to improve realism saw changes to the competition format, but the core function of testing individuals' knowledge on a simulated scenario remained. The Dewar Challenge Shield, presented by Sir Thomas Dewar, Sherriff of London, was inaugurated for competition by Divisions of the St John Ambulance Brigade in 1897, and it became the main trophy for competition for over a hundred years.