Journal of Healthcare Simulation - Subject

An escape room workshop to facilitate peer-to-peer teaching for interprofessional learners

2026-04-22T00:00

Quality education regarding best practices for managing the health and disease of older adults (OA) is needed. Interprofessional simulation education (Sim-IPE) is an active learning strategy that enables students from multiple professions to learn from, with and about each other to improve patient care. Student involvement in interprofessional educational events enhances valuable peer learning and engagement. This approach supports decision-making regarding a future geriatric care specialty and current challenges in care providers for OAs workforce. Escape rooms are an effective but resource-intensive Sim-IPE strategy. This essay describes the development and delivery of a workshop designed to support an interprofessional peer-to-peer educational project focused on the creation and delivery of an escape room educational experience concentrated on the 5Ms Framework (what Matters, Medication, Mentation, Mobility, Multicomplexity) of age-friendly care (AFC). The workshop promoted collaborative problem-solving and deeper engagement with OA care principles through peer-to-peer education.

Identification of latent safety threats involving on-site simulation in a Birthing Unit in response to the COVID-19 pandemic

2025-06-23T00:00

We aimed to detect different types of latent safety threats (LSTs) by using on-site simulations for pregnant women with suspected COVID-19 presenting to the Birthing Unit. We recorded LSTs during on-site simulations. There were three scenarios, which involved the presentation of a suspected patient to the Birthing Unit, donning and doffing, and transportation to the operating room. LSTs were subcategorized into Gaps in Knowledge and Training, Maintenance and Equipment, and System and Processes. Sixty-five participants were involved. Eighty-one LSTs were observed: scenario 1 (n = 42, 51.8%), scenario 2 (n = 14, 17.2%) and scenario 3 (n = 25, 30.9%). Amongst the different themes, Gaps in Training and Knowledge comprised (n = 29, 35.8%), Maintenance and Equipment comprised (n = 46, 56.8%), and Systems and Processes comprised (n = 6, 7.4%). Pre-simulation surveys revealed only 10% of participants felt very prepared to care for these patients, while 92% responded the same way post-simulation.

Twelve steps to design meta-simulation game worlds to foster the next generation of healthcare practitioners: the example of ‘The Carthage Codex’

2025-12-12T00:00

This article introduces the concept of ‘meta-simulation game world design’ for healthcare education. This innovative approach integrates multiple evidence-informed instructional strategies into a curated series of integrated and progressively complex simulation experiences (a meta-simulation) set within an immersive game world – a simulated, fictional universe governed by its own rules. Drawing on our experience designing The Carthage Codex, a meta-simulation game world for long-term care specialization, we outline our method and detail the 12 design steps, from initial planning to evaluation. Each step is illustrated with practical examples to guide and inspire readers in developing their own meta-simulation game worlds. Additionally, we emphasize the importance of ethical, cost-effective and reusable design practices to maximize educational impact and sustainability. This article aims to advance the integration of simulation, game-based learning and storytelling by presenting a flexible 12-step approach for designing immersive and impactful healthcare learning experiences.

Productive struggle and simulation design: actionable insights for designing engaging simulations

2025-11-06T00:00

Aristotle’s quote ‘For the things we have to learn before we do them, we learn by doing them’ captures a fundamental value of simulation-based education – learning through experience. Practising tasks before mastering them is an essential experience for many learners and underscores the value of struggle as integral to the learning process. In this regard, there is a strong synergy between simulation-based education and the principles of productive struggle. Both incorporate concepts of guided discovery, preparation for future learning and adaptive expertise. In productive struggle, learners first attempt to solve a problem before being provided with a correct or canonical solution, allowing them to compare and refine their understanding. Simulation-based learning emphasizes active discovery in the learning process, problem solving, skills development and deeper conceptual understanding. In this essay, we introduce the main features of productive struggle as an instructional approach and its value as a theoretical lens for simulation education design.

Human factors and translational simulation: misunderstandings and potential opportunities

2025-10-02T00:00

There are great synergies between human factors and translational simulation, with both approaches sharing the goal of improving patient care and the working lives of healthcare practitioners. However, a combination of misconceptions about human factors in the simulation community and a limited understanding of the capabilities of simulation within the human factors community means that the great potential for synergies between human factors and translation simulation remains unrealized. The field of human factors offers methods, models and theories to support simulationists to better understand their organizations. Translational simulation offers an ideal vehicle for human factors practitioners to engage in systems analysis and testing. Simulation also serves as a laboratory for research, design and development. Yet such collaborations are still relatively rare. Healthcare simulation is predominantly used for training, and human factors practitioners are largely unaware of the opportunity that simulation offers to support human factors work. We encourage members of both the simulation and human factors communities to build partnerships to the benefit of patients, healthcare workers and the entire healthcare system.

Harnessing the power of extended reality for medical training on Earth and in space

2025-06-30T00:00

Advances in extended reality technology can augment current training methods and reduce the time and resources required for medical training. We reflect on the National Aeronautics and Space Administration (NASA) as a leader in innovation and training. Medical educators can pull innovative concepts from NASA, used in training astronauts to manage unique operations in space before missions, to develop platforms capable of educating medical trainees on medical operations before exposure to live patients. These advancements in medical education are already present and evaluated in this review. We also aimed to review how these technological advancements can improve medical capabilities in health resource-constrained environments both in space and on Earth.

Educational principles in Tabletop Simulation: an overview

2025-04-09T00:00

Tabletop simulation (TTX) has emerged as an innovative educational tool within medical training, offering a unique approach to experiential learning. By simulating real-world scenarios, TTX allows learners to practice skills and make critical decisions in a low-risk environment. Traditionally associated with disaster preparedness and emergency response, TTX has now expanded into various non-emergency applications, demonstrating broad potential across healthcare domains. TTX’s structured yet flexible format allows for the enhancement of cognitive and interpersonal skills, such as communication, leadership, and teamwork, through collaborative gameplay.

This paper explores the current state of TTX, its educational principles, and its strengths and limitations. It provides up-to-date evidence-linked insights for educators and facilitators. Key essay themes include: 1) the role of prior learner knowledge and ability to facilitate learning, 2) specific motivational theories identifiable in current TTX games, and 3) the current state of TTX debriefing.

Within this work, several impressive, peer-reviewed studies linking TTX to educational practice are identified, and key underlying learning processes that can and should be exploited in TTX are explored. Overall, there is a clear trend towards developmental progression in the field of TTX on both commercial and home-grown levels. However, we find the current body of work is lacking and systematic work needs to be done in order to develop a coherent evidence base.

Scoping reviews: an approach to co-creation through consultation

2024-12-06T00:00

This paper introduces ‘co-creation through consultation’, a method providing structured direction for implementing, reporting and evaluating knowledge user engagement in scoping reviews. Drawing on our experience conducting a Best Evidence in Medical Education (BEME) scoping review, we retrospectively detail our ‘co-creation through consultation’ method. We outline our preparation, engagement strategies and ongoing consultation processes, highlighting knowledge user recruitment and methodological considerations. Our reflections underscore the significant influence of the impact of engaged research on the review’s outcomes and demonstrate the relevance and applicability of our scoping review findings. Our structured approach allowed for meaningful input from knowledge users without extensive time commitments. We present our approach with the intention of advancing the processes of engaging knowledge users in scoping reviews. We also advocate for transparent reporting of engagement processes in health professions education scoping reviews to promote evidence-informed practices.

The story of Sam: an ethical dilemma in simulation-based education

2025-04-11T00:00

The involvement of young people in simulated patient (SP) roles requires attention to a plethora of potential areas where harm can occur. Multiple individuals are involved in this process, and their engagement is crucial to safeguarding the young person’s welfare. The need to protect their well-being and psychological safety whilst adhering to ethical principles, safe practice and developmentally appropriate interactions is discussed through the story of Sam. As a young SP involved in role playing a challenging situation, Sam’s story relays important messages for those engaging young SPs.

Not just ‘what you say’ but ‘how you say it’: co-creating psychological safety through micro-communication skills in simulation-based education

2025-10-02T00:00

This essay builds on a previous editorial in which we posited that psychological safety is not something a simulation-based educator can ‘create’ or ‘ensure’ alone; that psychological safety is a relational concept. While simulation-based education often has critical technical elements, it has also been described as essentially a social practice. In this essay, we explore how micro-communication skills can contribute to shaping this social practice, and how simulation educators can use these practices to foster psychological safety and optimize learning. We argue for the use of micro-communication skills by simulation educators to shift from that notion of faculty ‘creating’ psychological safety to a position of ‘co-creating’ psychological safety with learners through mutual, responsive interactions. We propose how the social dynamic can be influenced through phatic communication, emotional pace setting, humour, physical/gestural communication, empathic communication, conversational pauses and turn-taking. By foregrounding the social dimensions of simulation-based education, we highlight how everyday communication choices shape learners’ experience, trust and growth.