Advances in simulation (London, England)最新文献

{"title":"The next frontier in healthcare simulation is human-AI teaming.","authors":"Sonia Jawaid Shaikh, Walter Eppich","doi":"10.1186/s41077-026-00479-y","DOIUrl":"10.1186/s41077-026-00479-y","url":null,"abstract":"<p><strong>Background: </strong>Across health professions, AI agents are moving out of the background and into clinical teams as collaborative entities. Yet healthcare simulation continues to conceptualise AI as a tool that serves the scenario rather than one that inhabits it. This framing is no longer adequate. The clinical environments we are preparing practitioners for demand that professionals learn to team with AI and not merely use it.</p><p><strong>Main body: </strong>We contend that human-AI teaming (HAIT) is the next frontier for healthcare simulation education and research. The addition of AI agents to human teams fundamentally alters how teams communicate, work together, and accomplish goals and therefore, by extension, how we must design simulation systems for education and research. We identify five dimensions of teamwork that AI is reshaping and discuss what each means for simulation practice: communication and information exchange, shared mental models, trust calibration, team reflexivity, and team performance. We then present five imperatives that healthcare simulation must address to meet the challenges and opportunities HAIT introduces: fidelity, assessment, ethics, governance, and medico-legal framing, curriculum and faculty development, and transfer of learning. Together, these ten domains constitute a research and education agenda for a field built on the science and art of preparation.</p><p><strong>Conclusion: </strong>HAIT is an emerging clinical reality and the next frontier for healthcare simulation. We call on the simulation community to treat it as a first-order priority and to focus on developing fidelity standards for AI agents in simulation, validating human-AI teaming assessment tools, establishing ethical frameworks for AI-inclusive scenario design, investing in curriculum and faculty development, and committing to the research needed to establish whether HAIT-based simulation training translates into improved performance in AI-augmented clinical practice.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":"11 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13651356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149149641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How does AI-generated assessment compare to expert assessment in simulation-based experiences: Analyzing AI-human interrater reliability.","authors":"Margaret Brace, Gail Furman, Lisa Diewald, Rebecca Shenkman, Stephanie Felgoise, Tracy Oliver","doi":"10.1186/s41077-026-00464-5","DOIUrl":"10.1186/s41077-026-00464-5","url":null,"abstract":"<p><strong>Background: </strong>In the health professions, artificial intelligence simulation-based experiences (AI-SBEs) are increasingly used to evaluate learner performance and provide feedback. Benefits of AI-SBEs include providing instantaneous feedback, allowing more practice opportunities than feasible using traditional methods, and reducing educator burden. However, methods for calibrating AI feedback are underdeveloped.</p><p><strong>Methods: </strong>This study evaluated the feedback provided by a generative AI-based software program (SimConverse) when assessing simulated patient interactions using the Weight Sensitivity Instrument (WSI), a checklist used to assess learners' weight bias-related clinical behaviors. A two-phase interrater reliability (IRR) approach was used. First, iterative prompt engineering was guided by AI-human IRR results. Four authors and four volunteers generated 31 interactions in SimConverse. Interaction transcripts were downloaded, and another author with expertise in the WSI manually reviewed and scored the transcripts. Percent agreement and Gwet's AC1 were calculated to compare AI and expert assessments, and the research team reviewed feedback statements and agreement statistics to identify rubric instructions in need of revision. After revising the rubric in SimConverse, four authors produced 10 additional SBE interactions. Expert and AI assessments were explored. In phase two, the AI-SBE was piloted with 60 medical students in a larger intervention study. A random sample of 30 student transcripts were assessed for AI-human IRR, and students' comments about the AI-SBE were reviewed.</p><p><strong>Results: </strong>Of the 11 WSI items, expert and AI agreement was consistently good or very good for 7 items across all rounds (Gwet's AC1=0.71 and higher). One item initially showed poor agreement (Gwet's AC1=0.56), but agreement improved after prompt engineering (final Gwet's AC1=0.89). The improved item assessed whether students made specific statements (asked if weight loss was a priority). Three other items had persistent poor agreement (final Gwet's AC1=0.42, 0.66, 0.64). These items required broader contextual assessment of the transcripts. Most open-ended student reactions to the AI-SBE were positive.</p><p><strong>Conclusions: </strong>Findings suggest that AI scoring and feedback within AI-SBEs requires iterative prompt engineering and educator/researcher guidance. Tuning was more successful for content-specific items than context-dependent items. Future work could explore best practices for prompt refinement, particularly for more complex and context-dependent rubric items.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":"11 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13644239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Translation, cross-cultural adaptation, and psychometric validation of the Team Emergency Assessment Measure (TEAM) into European Spanish: a multi-perspective study including peer-assessment.","authors":"Esther Leon-Castelao, Jose Luis Medina-Moya, Alejandro Durante-Lopez, Pedro Castro-Rebollo, Simon Cooper, Antoni Ruiz-Bueno, Jordi Bañeras","doi":"10.1186/s41077-026-00484-1","DOIUrl":"10.1186/s41077-026-00484-1","url":null,"abstract":"<p><strong>Background: </strong>The Team Emergency Assessment Measure (TEAM) is the most widely used tool for evaluating emergency team performance, with robust psychometric evidence across multiple languages and settings. However, no European Spanish version has been validated, and no previous TEAM study has simultaneously assessed teamwork from four complementary rater perspectives: instructors from the learners' own specialty, instructors from other specialties, self-assessment by the performing participants, and peer-assessment by observing peers. This study aimed to translate, culturally adapt, and psychometrically validate a European Spanish version of the TEAM (s-TEAM) and to evaluate its reliability and validity across these four perspectives in emergency simulation scenarios, with peer-assessment representing a novel contribution of this work.</p><p><strong>Methods: </strong>The TEAM was translated and adapted into European Spanish following internationally recommended guidelines. The s-TEAM was applied across 216 high-fidelity cardiology emergency simulation scenarios within nine editions of a national training programme for second-year cardiology residents organised by the Spanish Society of Cardiology. Ratings were collected simultaneously from all four perspectives. Internal consistency, item analysis, concurrent validity, and factor structure (EFA and CFA on independent subsamples using polychoric correlations) were examined.</p><p><strong>Results: </strong>A total of 145 residents were registered across the nine course editions, with 30 participating instructors and 216 scenarios. The final analytical sample comprised 1,414 valid ratings. Internal consistency was excellent overall (Cronbach's α = 0.921) and across all rater groups (range 0.901-0.938). The total score correlated strongly with the Global Rating Scale (r = .816). Factor analysis supported a predominantly unidimensional structure with a distinguishable Leadership/Communication facet (interfactor correlation 0.904-0.908). Peer-assessment yielded reliable scores (α = 0.901) comparable to other rater groups. Instructors from the residents' own specialty (cardiologists) scored significantly lower than all other groups (d = - 0.42). Internal consistency was stable from the first scenario (α = 0.900) despite the absence of formal rater training.</p><p><strong>Conclusions: </strong>The s-TEAM is a valid, reliable, and feasible European Spanish adaptation of the TEAM. It produces consistent scores across four rater perspectives, enabling multi-source feedback during debriefing without additional faculty. These findings support its integration as both an assessment and formative tool within iterative simulation curricula.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":"11 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Virtual patients and learning communication skills at \"double speed\": a qualitative study using the TPACK framework.","authors":"Criona Maria Walshe, Catherine Bruen, Ronan Daly, Fiona Kent","doi":"10.1186/s41077-026-00481-4","DOIUrl":"10.1186/s41077-026-00481-4","url":null,"abstract":"<p><strong>Background: </strong>Effective communication is central to patient-centred care, but achieving sufficient practice opportunities with access to expert feedback during busy clinical placements can be challenging. Virtual Patients (VPs) simulate doctor-patient consultations and have been used successfully in medical education to teach communication skills. Four VPs were created with filmed patient encounters, using a branching decision format and scripted expert clinician feedback, to provide students with opportunities to practise challenging, infrequently seen, communication encounters.</p><p><strong>Methods: </strong>One focus group and six individual interviews were conducted with medical students as a quality improvement measure prior to the implementation of VPs into the year 4 medical curriculum. After transcription, deductive thematic analysis was undertaken using the TPACK framework as a conceptual lens to examine technological, pedagogical, content and contextual knowledge.</p><p><strong>Results: </strong>Students described the VP content as authentic, emotive and supportive of their clinical, communication and cultural learning. They reported enhanced confidence through scaffolded exposure, but emphasised VP inferiority to real-world patient encounters. Pedagogically, students learnt through observation of videos modelling good communication under challenging circumstances, such as communication of a miscarriage, and suicide risk assessment following self-harm. However, students tended to skip or minimise VP reflective tasks, and they described the automated feedback as didactic and non-memorable, limiting educational impact. Students' technology expectations exceeded the platform capabilities. They sought to speed through sections where possible and the VP activity was described as \"clicking\", rather than communicating. Despite these limitations, students gained contextual knowledge and suggested the integration of VP into the curriculum as preparatory learning rather than communication skills practice, as they recognised that despite enhanced confidence, mastery requires repeated engagement with real or simulated patients.</p><p><strong>Conclusions: </strong>This VP platform did not meet the needs of students to practise challenging communication skills, with technology insufficiently integrated to align content delivery to pedagogical intent. Our findings suggest that although useful to complement live or simulated patient communication encounters, to realise their potential, VP technologies must enable more authentic interactivity such as voice-to-text, nuanced individualised feedback and stronger alignment between TPACK domains.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":"11 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13615569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149066659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contextualizing the ASPE standards of best practice: reflecting on the past, present, and future of SP methodology.","authors":"Amelia M Wallace, Cory Krebsbach, Janice Radway, Lou Clark","doi":"10.1186/s41077-026-00480-5","DOIUrl":"10.1186/s41077-026-00480-5","url":null,"abstract":"","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":"11 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13464367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148727318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Rethinking real-time learning in debriefing: liminality, microgenesis, and semiotic borders.","authors":"José Luis Medina, Gabriel Hervas, Isaac Calduch, Patricia Silva, Esther León","doi":"10.1186/s41077-026-00473-4","DOIUrl":"10.1186/s41077-026-00473-4","url":null,"abstract":"","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":"11 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13397970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148581430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simulation-enhanced interprofessional education in surgery - a scoping review.","authors":"Sean Stevens, Oscar Morice, Deborah Colville, Vijayaragavan Muralidharan, John Paige, Debra Nestel","doi":"10.1186/s41077-026-00453-8","DOIUrl":"https://doi.org/10.1186/s41077-026-00453-8","url":null,"abstract":"<p><strong>Introduction: </strong>Simulation-enhanced interprofessional education (Sim-IPE) has been successfully used in various health professions and shown to improve communication and teamwork. Surgery, where preventable serious adverse outcomes are often attributed to issues with communication and teamwork, represents a compelling context for Sim-IPE. However, implementing Sim-IPE in surgery requires investment in faculty development, equipment and facilities while incurring the cost of reduced staff availability and theatre productivity during simulation activity. We conducted a scoping review to characterise how Sim-IPE in surgery is practised and researched.</p><p><strong>Methods: </strong>This scoping review followed the methodological framework described by Arksey and O'Malley. Reporting followed the PRISMA-ScR checklist. Electronic databases (Medline, EMBASE, Web of Science, PsycINFO and ERIC) were searched for records pertaining to Sim-IPE in surgery published after 1st January 2000 and in English.</p><p><strong>Results: </strong>The final analysis included 81 articles. Simulation scenarios showed a rich variety of combinations of professions, disciplines, training levels and settings. While most scenarios used manikins (N = 54, 75%), other modalities included simulated participants, cadavers, task trainers, computers, laparoscopic simulators, role play and animal models with many scenarios using multiple modalities (N = 20, 27.8%). Of studies reporting on evaluation outcome, almost half (N = 32, 47.1%) were limited to participants' views of their learning experience and satisfaction with the program. Few studies reported using educational theory to inform Sim-IPE design and even fewer used theoretical frameworks in the research design. Facilitators for implementing Sim-IPE in surgery included a skilled faculty, institutional support and evidence of benefit. Barriers included lack of protected training time, restricted access to facilities and unreliable ongoing funding.</p><p><strong>Discussion: </strong>Studies described a rich variety of Sim-IPE scenarios, including multiple professions, disciplines, training levels, simulation modalities and settings, facilitating training in a broad range of skills reflective of the complexity of modern surgical care. While barriers such as time, funding, and cultural resistance to simulation are commonly reported in the simulation-based education literature, these issues may be amplified in surgery due to surgical service pressures and traditional hierarchies (e.g. surgeon as \"captain of the ship\"). Overcoming these barriers will likely require structural (policy, funding, scheduling) and cultural (leadership, team identity) change.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":"11 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149225524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Collaborative, digital and sustainable skills through multimodal simulations: evidence-based, interprofessional training in primary health care - the REALISE study.","authors":"Christine Kern, Melanie Roth, Marlene Brunner, Eva Maria Bamberger, Joachim Schulze, Gertie Janneke Oostingh, Daniela Huber","doi":"10.1186/s41077-026-00468-1","DOIUrl":"https://doi.org/10.1186/s41077-026-00468-1","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Interprofessional collaboration is crucial for enhancing healthcare delivery, particularly in primary care settings, where effective teamwork between healthcare and social professionals (HCSPs) is essential. Despite its importance, there is limited research on the impact of structured interprofessional training programs on interprofessionality in simulated environments, particularly concerning primary care contexts.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The REALISE study constitutes of a prospective feasibility study examining the impact on interprofessionality of multimodal, interprofessional learning paths on HCSPs as well as students within a simulated primary healthcare (PHC) setting. The three-week learning paths were specially developed, proprietary, case-oriented, and consisted of simulations (acting patients, high-fidelity manikins, virtual reality) and didactic on- and offline elements. The study employed a mixed-methods approach, incorporating three conducted interprofessional intervention groups to evaluate outcomes across both quantitative (two standardized assessments: Interprofessional Collaborative Competency Attainment Survey (ICCAS), Interprofessional Socialization and Valuing Scale 9a&b (ISVS)) and qualitative (proprietary open-ended questions) domains. Data was collected before (t0), directly after (t1) and two months after t1 (t2) to evaluate the impact on interprofessional collaboration.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Regarding the quantitative outcomes, no significant change was observed in participants' ISVS scores between pre- and post-intervention assessments, neither in the entire sample (t0 = 5.41 ± 1.20, t1 = 5.85 ± 1.18; p = 0.108), nor in the student or HCSP group. Also, no time*group effects became evident. This suggests stable self-perceived values and attitudes toward interprofessional collaboration. In contrast, ICCAS scores increased significantly in total and across all dimensions (e.g., total score t₀ = 3.00 ± 0.77, t₁ = 3.99 ± 0.53; p &lt; 0.001, d = 0.91). The strongest effects for the entire sample were observed in the dimensions \"Team Functioning\" (0.973) and \"Collaboration\" (0.922) and significant time*group (students vs. HCSPs) effects were found in 3 of the 6 dimensions (\"Collaboration\", \"Roles and Responsibilities\" and \"Team Functioning\"), indicating substantial self-reported improvements in interprofessional competencies following the training and differences in amplitude of improvements. The results of the qualitative thematic analysis showed clear differences and overlaps between groups and time points. At t0, the students described communication difficulties, unclear responsibilities and role confusion as central challenges. In contrast, HCSPs focused on structural problems such as time pressure and limited coordination. At t1, the students reported increased role clarity and improved team communication, while HCSPs noted greater awareness of their own role and greater flexi","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":"11 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149229451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thai nursing students' experiences of stress, role positioning, and facilitation tone in simulation-based learning: implications for culturally responsive facilitation and debriefing.","authors":"Trakulwong Luecha, Charunyakorn Viriya, Nattaya Sangsai, Patcharin Poonthawe, Witchaporn Kidsamrong, Warisa Kanbuala, Puntaree Pikulnee, Paweena Tivasiripong","doi":"10.1186/s41077-026-00472-5","DOIUrl":"10.1186/s41077-026-00472-5","url":null,"abstract":"<p><strong>Background: </strong>Simulation facilitation models have developed predominantly in Western educational settings. The ways in which cultural norms, particularly kreng-jai and deference to authority, shape nursing student participation in high power-distance contexts have received limited empirical attention.</p><p><strong>Objectives: </strong>This study examined how stress, role positioning, and facilitator feedback timing and tone interact to shape participation and culturally safe learning in simulation-based nursing education in Thailand.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted in Thai with 24 third- and fourth-year nursing students in Eastern Thailand between August and October 2024. Interviews lasted 45-60 min and were analysed using reflexive thematic analysis.</p><p><strong>Results: </strong>Four themes were developed. Entering a New Space positioned simulation as a threshold where visibility intersected with kreng-jai-patterned restraint; students' reluctance to speak was culturally rational rather than disengagement. Stress as a Double-Edged Sword in Simulation showed that pressure could sharpen recall and prioritisation but could also narrow participation when abrupt feedback arrived mid-scenario. Learning Across Participation, Observation, and Debriefing identified distinct but complementary learning routes: active scenario participants acted under time pressure, whereas observers developed an analytic perspective, with both perspectives converging during debriefing. Facilitation and Cultural Safety found that calm guidance kept kreng-jai compatible with engagement, whereas abrupt correction rendered silence a response to relational risk.</p><p><strong>Conclusion: </strong>Participation and psychological safety in simulation were not inherent features of instructional design but were interactionally and culturally mediated through facilitation, role positioning, and hierarchical norms.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148498366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Designing a context-sensitive faculty development architecture for simulation facilitators: lessons from a practice-based implementation.","authors":"Daniel Gonçalves Campos, Juliany Lino Gomes Silva, Fernanda Magalhães Arantes-Costa, Ana Railka de Souza Oliveira-Kumakura","doi":"10.1186/s41077-026-00465-4","DOIUrl":"10.1186/s41077-026-00465-4","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Simulation-based education is widely recognised as a key strategy in health professions training, yet the quality and sustainability of simulation initiatives depend heavily on the preparation of faculty responsible for facilitation, scenario design, and debriefing. While international standards provide guidance for simulation practice, implementing faculty development programs can be challenging in institutions characterised by limited resources, high teaching workloads, and heterogeneous faculty experience. Detailed accounts of how such programs are designed, implemented, and sustained within real institutional constraints remain limited.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main body: &lt;/strong&gt;This paper describes the design, implementation, and reflective analysis of a hybrid faculty development architecture for simulation facilitators developed within a Brazilian higher education institution. The program was informed by experiential learning theory, adult learning principles, and implementation science perspectives, and was developed following an institutional needs assessment. The architecture combined asynchronous preparatory learning, synchronous online discussions, and experiential in-person workshops focused on scenario design and debriefing practice. A six-month responsive longitudinal support component was incorporated to facilitate transfer of learning into authentic teaching contexts. Communication and reinforcement mechanisms were integrated into institutional digital platforms already used by faculty in order to minimise participation barriers. Implementation indicators demonstrated feasibility and high participant acceptability within the institutional context. Implementation revealed both strengths and tensions. The structured experiential phase proved operationally stable and aligned with faculty learning needs. However, utilisation of the optional mentorship component remained limited, highlighting the challenges of sustaining engagement in contexts characterised by competing professional demands. Descriptive readiness profiles suggested developmental progression among participants, although the architecture was not designed as a formal competency assessment framework. Reflective analysis of the implementation process allowed the identification of design principles related to feasibility, contextual adaptation, reinforcement strategies, and institutional integration.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This practice-based account illustrates how simulation faculty development initiatives can balance pedagogical rigour with contextual feasibility. Rather than proposing a new competency framework, the architecture offers an implementation-oriented approach for supporting faculty development in resource-constrained educational environments. The experience suggests that foundational experiential training, flexible reinforcement strategies, and integration within existing institutional ecosystems may offer transferable insi","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13651310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148457674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}