Let’s stop pretending. Simulation isn’t a game anymore.
What began as an educational experiment, with computer-enhanced mannequins and enthusiastic pioneers, was long treated as a nice-to-have. Now, it is a must-have. Simulation trains critical thinking, develops psychomotor skills, reveals system flaws, and yes, saves lives! We have evidence of this. The literature is now full of examples.
Simulation is no longer just a teaching tool. It is now evolving into a vital component of healthcare systems. But while its impact has grown, the field itself has not kept pace in terms of structure, recognition, and regulation. We have research, technology, innovation but no consistent professional or institutional framework to support simulation across contexts.
It’s time to change that. It’s time to professionalize the entire field of healthcare simulation: its practices, programs, technologies, governance, and its people.
Simulation affects real-world outcomes. Poorly designed or poorly integrated simulations can reinforce bad habits, waste time, or even create dangerous assumptions. High-quality simulation, on the other hand, transforms clinical practice, challenges thinking, and strengthens systems. But the difference is not only in the people, it’s in the systems behind them.
Would we accept unregulated medicine? Unlicensed engineering? Then why are we still accepting unsystematic, inconsistent, under-recognized simulation practice? And why should our decision-makers have confidence and invest in such an unstructured sector?
It’s time to professionalize this sector of healthcare.
Let me explain. Professionalization is not a buzzword. It’s a necessary step toward ensuring quality, safety, and trust. It means establishing and upholding a shared framework of professional competencies, defining standards, building reliable structures, ensuring accountability, and embedding simulation as a recognized and respected domain in healthcare. Let’s be clear: professionalization does not mean overregulation. The goal is not to impose rigid bureaucracy or create gatekeeping mechanisms that stifle innovation. Rather, good regulation protects the integrity of the profession while allowing flexibility and adaptation. And it reassures learners, colleagues, institutions and the whole community that simulation is a credible, evidence-informed, and ethically sound endeavor.
Around the world, the simulation movement is growing but often without cohesion. In this issue of SIMZINE, we see examples that illustrate both the promise and the gaps.
In Jordan, as described by Dr. Jomana Alsulaiman, a national simulation conversation is underway. Deans, clinicians, and policymakers are working to align goals, resources, and infrastructure. But the challenges are familiar: fragmented curricula, underfunded centers, and inconsistent faculty training. Without a shared regulatory and professional foundation, momentum risks stalling.
A similar story emerges from Spain, where the SESSEP highlights the uneven development of hospital-based simulation. Despite strong evidence and political support, clinical simulation in hospitals remains inconsistently implemented. The call to action: clear institutional frameworks, sustainable funding, and formal integration into healthcare systems.
Meanwhile, a small hospital in Switzerland offers a model of how simulation can go beyond education. The SIMPASS project, as told by Giovanni Rabito, has turned simulation into a lever for risk management and process improvement. It’s an example of simulation functioning as a mature, systemic tool, not just a pedagogical one.
Professionalism doesn’t mean only high tech or high theory. The tools of simulation, in fact, are evolving rapidly. Laura Gonzalez and Desiree Diaz explore how artificial intelligence is accelerating scenario design, making adaptive learning a reality. But their message is sobering too: innovation without oversight can lead to chaos. If we don’t set the rules of our own game, someone else [or some algorithm] will.
Even the emotional core of our work needs better structure. Vincent Grant and Adam Cheng dig into the messy but essential role of emotions in debriefing. Do we engage, or avoid? Their answer: we must be skilled enough to know when and how to navigate the emotional terrain. That, too, is professionalism.
Sometimes professionalism means climbing a mountain, literally! In Tolmezzo, Italy, a team of clinicians runs monthly in-situ simulations in a small maternity unit. Their project, featured in this issue, shows that even with limited resources, simulation can transform team culture, build trust, and improve response in critical situations. But none of it happens by accident. It requires structure, repetition, leadership.
Whether it’s moulage innovation from Indiana, or insights from the daily life of a simulation industry leader like Sil Fon Tang, what ties all these stories together is the urgent need to recognize simulation as a structured field, not anymore as an informal craft.
Professionalizing healthcare simulation means building a culture of quality, not just among simulationists, but across institutions, systems, and sectors. It means integrating simulation into policy, certifying competencies, investing in infrastructure and creating strategic frameworks that support both education and clinical safety.
It’s not enough to believe in simulation. Now we must build a discipline.
PLI
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