The Adaptability of Simulation 

Pier Luigi Ingrassia
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Our editor-in-chief Pier Luigi Ingrassia comments on how the adaptability of simulation enhances healthcare education across diverse contexts and disciplines, and presents what is new in the latest issue of SIMZINE

Very often we talk about the adaptability of simulation, but without perhaps understanding its true meaning. But this issue of SIMZINE I think exemplifies this concept, referring to its usefulness. Whether implemented in resource-limited rural hospitals or sophisticated academic institutions, simulation consistently proves its value by adapting to the unique challenges of each environment. And let me explain how simulation rises to meet diverse needs, as demonstrated in a number of thought-provoking articles. May Sissel Vadla’s Implementation of Simulation When Time is Scarce, and Resources Are Limited” highlights how adaptability in simulation can lead to profound improvements in clinical outcomes, even when faced with considerable resource constraints. Vadla recounts the journey of a rural hospital in Tanzania, where staff improved care for non-breathing newborns by embracing low-cost, high-impact simulation techniques. Over six years, despite having limited equipment and personnel, the hospital achieved remarkable success through repeated, carefully structured simulations. This case underscores that the true power of simulation lies not only in high-technology equipment but in its skillful application, allowing even resource-strapped facilities to achieve better outcomes through hands-on learning and iterative improvement.

On the opposite end of the spectrum, Richard Helyer’s Virtual Patients to Teach Large Classes: The University of Bristol Experience showcases simulation’s adaptability in a completely different context. Teaching physiology to large groups of students requires innovative methods to ensure engagement and retention. Helyer and his team leveraged virtual patient simulations to create an interactive learning environment for up to 250 students simultaneously. This approach allowed students to actively participate in the simulation, fostering deeper engagement and understanding, despite the large class size. The University of Bristol’s success highlights how simulation can be scaled to meet the challenges of modern education, maintaining interactivity and active learning even when traditional methods might falter.

These contrasting stories, from a rural Tanzanian hospital to a large academic institution in the UK, emphasize simulation’s remarkable ability to adapt to varying circumstances and demands. This adaptability is further illustrated by other articles in this issue, which examine simulation’s integration into broader healthcare systems.

Take, for example, the insights shared by Luca Carenzo and colleagues in Clinical Governance: Hard Wiring Quality and Simulation. Their article delves into the underutilized potential of in-situ clinical simulations to improve patient safety by addressing real-world risks. In many healthcare settings, clinical governance structures exist to ensure accountability and continuous quality improvement. However, simulation often remains siloed as a training tool rather than being integrated into these systemic safety efforts. Carenzo argues that clinical simulation—particularly in-situ simulations that occur within real clinical environments—has untapped potential to proactively identify risks, enhance incident reporting, and drive structured debriefings that lead to meaningful, data-driven improvements in patient care. In this way, simulation can be a vital component of clinical governance, hard-wiring quality and safety into the fabric of healthcare delivery.

But if we talk about the adaptability of simulation, we also cannot fail to highlight its versatility in addressing a variety of healthcare disciplines. For instance, Francesca Innocenti and colleagues’ article Simulation for Cardiopulmonary Resuscitation Training demonstrates how simulation can be tailored to highly specific clinical skills. Cardiopulmonary resuscitation is a critical, life-saving procedure, and the authors explore how simulation-based training can provide healthcare workers with hands-on practice. But simulation can transcend traditional clinical emergency boundaries. And gives us an example Marcela Stambullian in her article Escape game based on clinical simulation for teaching nutrition, where simulation is applied to a completely different discipline: nutrition. In this innovative approach, the team developed an escape-room-style simulation to teach clinical nutrition concepts. This playful yet educational format enabled students to engage with complex nutritional challenges in a highly immersive and interactive way. 

This ability to move from one role to another, either as a training tool or as a mechanism for systemic improvement, or to embrace such diverse disciplines further underscores the adaptability of simulation. Simulation is a versatile tool that can meet a variety of needs. Then, we have to make the best use of it.

Pier Luigi Ingrassia
Author

Pier Luigi Ingrassia

Centro di Simulazione (CeSi), Centro Professionale Sociosanitario Lugano View all Posts

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