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Healthcare Simulation Equity
High costs associated with simulation equipment and resources remain one of the biggest barriers to equitable access in healthcare simulation. When only well-funded institutions can afford realistic learning tools, inequity widens. The Global Consensus Statement on Simulation-based Practice noted, “equitable access to high-quality, contextually relevant simulation-based learning opportunities as a global priority” (Diaz-Navarro, et. al, 2024). Creating affordable yet realistic simulation materials is a key solution to this global challenge. By thinking creatively and using available resources, simulationists can design impactful learning experiences without high financial investment.
This article highlights three smart strategies to boost healthcare simulation equity worldwide.
1.Upcycling and Innovation
Reusing and repurposing materials is one of the most effective ways to lower simulation costs. Supplies such as intravenous (IV) tubing, simulated medications, syringes, and oxygen delivery devices, which are typically single-use in clinical practice, can be safely reused in simulation settings. Repackaging materials can also be creatively adapted to mimic new products at a fraction of the cost.
Equipment can often serve multiple roles. A stretcher, for example, can double as an exam table for outpatient scenarios. Similarly, maximizing the use of current accessible technology is paramount. For example, using phones speakers may be used for communication with the learners in the simulation, or using cell phones as patient monitors (ResusMonitor, 2025). Students can also record and review their own performance using their mobile devices, turning everyday technology into powerful reflective learning tools.
Purchasing from nontraditional sources further stretches limited budgets. An infant scale for simulation equipment vendor may cost significantly more than an equivalent model from an online retailer. Creative simulationists often substitute food items, such as red dye and gelatin, to simulate blood or bodily fluids, although these materials require careful consideration regarding storage, hygiene, and disposal. In resource-limited settings, using food as simulation material may raise ethical or practical challenges when food scarcity is an issue (Bulamba et al., 2019).
Maximizing Donations
Donations can dramatically increase access to simulation materials. Local hospitals, clinics, and health agencies often dispose of expired clinical supplies that, while no longer safe for patient use, are still perfectly suitable for simulation.
When manikin technology reaches the end of its end of life, it can be repurposed as a task trainer by removing or adapting its internal components. However, it’s important to consider the practical limitations of donated materials, especially in underserved areas, where replacement parts, batteries, or repair expertise may be difficult to obtain or prohibitively expensive. For example, finding and purchasing batteries to run the donated equipment takes great deal of time/gas, is expensive (>$50), and therefore not sustainable.
Even broken equipment can enhance environmental fidelity (INACSL Standards Committee, 2021). A non-functional suction machine, for example, can still be useful in simulation spaces in meeting learning objectives. Students can assemble, connect tubing, and visually assess suction container contents.
Running a simulation program on unplanned donations is difficult and may create some challenges when planning content in the curriculum.
Share Globally
Perhaps the most powerful, and cost-free, strategy for simulation equity is global collaboration. Many organizations and initiatives freely share low-cost simulation resources online, including CAN-SIM (2025), Lowcosim (2025), the National League for Nursing (2025), and ResusMonitor (2025).
Please consider contributing to online the low-cost resource “recipes”, equipment ideas, or joining a low-cost special interest group in simulation organizations. Take pictures of your innovations, leave contact information, and continue to explore ways to meet the needs of learners. Readily sharing low-cost solutions will improve healthcare simulation equity across the world.
Conclusion
Healthcare simulation equity can be advanced through upcycling and innovation, maximizing donations, and sharing globally. These strategies empower educators to stretch their budgets, reduce waste, and expand access to meaningful learning opportunities. These efforts ultimately contribute to better training for healthcare professionals and improved patient safety in across the world.
References
Edmondson, A. C., & Lei, Z. (2014). Psychological safety: The history, renaissance, and future of an interpersonal construct. Annual Review of Organizational Psychology and Organizational Behavior, 1(1), 23-43.
Fiske, S. T. (2015). Perceived intent motivates people to magnify observed harms. Proceedings of the National Academy of Sciences of the United States of America, 112(12), 3599–3605.
Hallmark, B., Brown, M., Peterson, D. T., Fey, M., Decker, S., Wells-Beede, E., Britt, T., Hardie, L., Shum, C., Arantes, H. P., Charnetski, M., & Morse, C. (2021). Healthcare simulation standards of best practice: Professional development. Clinical Simulation in Nursing, 58, 5–8. https://doi.org/10.1016/j.ecns.2021.08.007
O’Connor, C., & Joffe, H. (2013). Intercoder reliability in qualitative research: Debates and practical guidelines. International Journal of Social Research Methodology, 16(4), 1-18.Wiley, D., Williams, J., & Sprott, T. (2017). The reviewer’s dilemma: Balancing fairness and critical feedback in academic publishing. Ethics & Behavior, 27(6), 480-491.
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