Prediction Factors Associated with Success in Military Special Operations Courses: A Systematic Review

Clinical Snapshot

Key Findings

• P Value: Not reported in the abstract

• Effect Size: Specific pooled standardised mean differences or weighted mean differences not reported in the abstract; directional associations reported for VO2max, pull-ups, push-ups, and marching performance (positive associations with success) and body fat percentage and sit-up performance (no significant association)

• Primary Outcome: Course completion success (pass vs. fail/attrition) in Special Operations selection and training courses

• Nnt Or Sensitivity: Not applicable as reported; no predictive accuracy metrics (sensitivity, specificity, AUC, likelihood ratios) reported for screening tool performance

• Confidence Interval: Not reported in the abstract

Clinical Application

The identified predictors (VO2max, pull-ups, push-ups, marching performance, psychological resilience) are largely already incorporated into existing military fitness standards and selection frameworks. Implementation of enhanced pre-selection screening based on these factors is operationally feasible with existing military physical and psychological assessment infrastructure. However, the low to very low GRADE certainty rating means that specific cut-off values or screening protocols cannot be reliably derived from this review alone. The Australian Defence Force (ADF) conducts Special Operations selection through the Special Air Service Regiment (SASR) and 2nd Commando Regiment selection processes. The findings are broadly consistent with ADF physical fitness standards and the existing Special Operations Command Australia (SOCOMD) selection framework. There are no PBS or TGA regulatory implications. The RACGP has limited direct jurisdiction over military medical practice; however, Defence Health Services and the Australian Army Medical Corps would be the relevant bodies for translating these findings into pre-selection health screening protocols. Australian military exercise physiologists and psychologists embedded in SOF units may find the psychological resilience and aerobic capacity findings useful for candidate preparation programs, noting the low evidence certainty. The multinational sample including likely representation from Five Eyes partner nations (US, UK, Canada, New Zealand) enhances relevance to the Australian military context. Military personnel undergoing Special Operations Forces (SOF) selection and training courses; military medical officers, exercise physiologists, and psychologists involved in pre-selection screening and candidate preparation programs

Abstract

BACKGROUND: We investigated factors associated with military personnel success in Special Operations courses (course pass or fail). METHODS: A systematic search was conducted across eight databases using the keywords "Special Operations" and "attrition." Sample size and profile data, course characteristics, predictive factors, follow-up, and results were extracted from the studies. We compared the means of the variables associated with success between the groups that completed and did not complete the courses. A meta-analysis was conducted for factors assessed by two or more studies, pooling standardized or weighted mean differences using fixedor random-effects models. RESULTS: A total of 23 studies were included. They were published between 1990 and 2022, included samples from 10 nations, lasted between 5 days and 12 months, and ranged from 11 to 1,138 individuals. VO2max, pull-ups, push-ups, and marching performance showed consistent positive associations with course success, while body fat percentage and sit-up performance did not. Certainty of evidence was rated as low to very low using the Grading of Recommendations Assessment, Development, and Evaluation. CONCLUSION: The factors that increased the probability of success in Special Operations courses were character strengths, recidivism in the course, anthropometric data, performance on physical assessment tests, psychological dissociation, psychosocial resources, blood markers, smoking/alcohol consumption, personality, and psychological strength. These findings support the inclusion of aerobic capacity, muscular endurance, and psychological resilience in early screening and preparatory selection processes.

References

1. 1.Tourinho, P. M., de Souza, L. M. L., Filho, M. V. A., Miranda, M. E. K., Viana, B. F., Alves, D. de S., & Bunn, P. dos S. (2026). Prediction factors associated with success in military special operations courses: A systematic review. Journal of Special Operations Medicine: A Peer Reviewed Journal for SOF Medical Professionals. Advance online publication. https://doi.org/10.55460/J.Spec.Oper.Med.2026.MST7-23AU