Advances in simulation (London, England)最新文献

{"title":"Teaching raters to see: A faculty development innovation for robust assessment in health professions education.","authors":"Lon Setnik, Yoon Soo Park, Clément Buleon, Demian Szyld, Jenny Rudolph","doi":"10.1186/s41077-026-00439-6","DOIUrl":"10.1186/s41077-026-00439-6","url":null,"abstract":"<p><p>Trustworthy simulation-based assessment depends on capable raters-but current approaches to rater training are often resource-intensive, inconsistently effective, and conceptually muddled. In practice, many programs focus on delivering training activities (e.g., frame-of-reference or behavioral observation training) without a clear model of the steps that build reliable, trustworthy assessments.We clarify the pathway to reliable, trustworthy assessment skills by distinguishing rater cognition-the cognitive work of recognizing, interpreting, and judging performance-from rater training, the educational processes intended to develop that capability. Rating is not a mechanical act of applying a rubric; it is a skilled perceptual and interpretive process. As we argue, a rubric does not do the seeing for you. While rubrics externalize expert judgment, raters must be trained to recognize and apply that expertise-learning to distinguish observable data from inference and to \"see through the eyes of the rubric.\" Traditional rater training approaches can be reframed as mechanisms that build this underlying cognitive skill.Building on this conceptual clarification, we introduce a staged learning framework for rater readiness. Rather than treating training as a one-time intervention, we propose that raters must be prepared developmentally: first through foundational deliberate practice, then through situational application, and finally through expert-facilitated calibration and ongoing feedback.We illustrate this model through a pilot of an interactive, technology-enabled, partially asynchronous rater training program for the Advocacy-Inquiry Rubric. This pilot shows how simulation programs can greatly reduce the time required from experts to train raters, while also demonstrating feasibility, strong usability, and promising reliability outcomes.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13289436/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846780","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":"Health and safety considerations for healthcare simulation: a scoping review of published literature.","authors":"Angela O'Dea, Paul O'Connor, Sinéad Lydon, Bronwyn Reid-McDermott, Dara Byrne","doi":"10.1186/s41077-026-00443-w","DOIUrl":"10.1186/s41077-026-00443-w","url":null,"abstract":"<p><strong>Background: </strong>The unique environments created within healthcare simulations may create distinct health and safety risks for patients, learners, simulation faculty and staff, and other participants involved in these activities. Guidance to aid simulationists to manage the physical risks arising from simulation activities is limited and there is no integrated synthesis of known risks or risk mitigation strategies.</p><p><strong>Objectives: </strong>To identify and examine literature addressing the physical health and safety risks associated with healthcare simulation, in order to inform the development of effective safety management strategies.</p><p><strong>Methods: </strong>This review included published empirical research and non-empirical literature (e.g., commentaries, editorials) examining physical health and safety risks associated with any form of healthcare simulation programme, event, or facility. A multi-pronged search strategy was used including electronic databases, Google Scholar searches, and reference list searches of literature published between 2010 and 2025. Risks, contributory factors and mitigation strategies were identified and mitigation strategies were coded according to the Hierarchy of Controls framework.</p><p><strong>Results: </strong>Sixteen articles were included. The literature most frequently identified physical health and safety risks to patients during in-situ simulation. Risks to participants and simulation staff or faculty were reported less often and primarily related to exposure to clinical equipment and musculoskeletal injury associated with the physical demands of simulation. Risks to simulated participants included clinical interventions being performed on them. Contributory factors included learner inexperience and failure to recognise risks, rule violations, pursuit of realism in simulation, poor simulation design, inadequate preparation, and lack of formal safety systems. Mitigation strategies were predominantly administrative, with rules, procedures, and checklists reported in 94% of sources, while elimination and engineering controls appeared in 37% and 19% respectively. There was call for clinical governance tools and processes to support a robust simulation health and safety approach.</p><p><strong>Conclusions: </strong>These findings highlight the need for co-designed, simulation-specific governance tools, including standardised risk assessments, adverse event reporting systems, and safety policies tailored to simulation environments. These tools should be embedded within, and aligned to the parent organisation's health and safety governance process, rather than constituting a separate or parallel governance process.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13317352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147824309","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":"Impact of an augmented reality-based decision support system on teamwork, leadership, provider workload and cognitive load during simulated cardiac arrest - a simulation-based randomized controlled trial.","authors":"Adam Cheng, Sergio Manzano, Johan N Siebert, Alexandre De Masi, Jennifer Davidson, Kangsoo Kim, Frédéric Ehrler, Delphine S Courvoisier, Donovan Duncan, Ana Rajic, Sharleen K Olanka, Ryan Kang, Yiqun Lin","doi":"10.1186/s41077-026-00444-9","DOIUrl":"10.1186/s41077-026-00444-9","url":null,"abstract":"<p><strong>Background: </strong>In cardiac arrest management, cognitive aids provide prompts to encourage recall of critical information, which may improve clinical performance. Whether cognitive aids influence provider workload, cognitive load, teamwork dynamics, or leadership during cardiac arrest remains unknown. In this study, we evaluated the effect of using a multi-faceted decision support system with augmented reality-based cognitive aids (i.e. InterFACE-AR) vs. the American Heart Association (AHA) Pediatric Advanced Life Support (PALS) pocket card on provider workload and cognitive load, teamwork, and leadership during simulated pediatric cardiac arrest.</p><p><strong>Methods: </strong>We conducted secondary analysis of data collected from a prospective, randomized controlled trial comparing the use of the InterFACE-AR system to the AHA PALS pocket card during simulated pediatric cardiac arrest. Participants were recruited in groups of 3 to perform the roles of team leader, medication nurse, and documenting nurse. All teams completed a 12-min simulated cardiac arrest scenario. Provider workload (NASA-RTLX) and cognitive load (Paas score) were captured from participants after the scenario. Teamwork (TEAM score) and leadership performance (CALM score) were assessed via video review.</p><p><strong>Results: </strong>A total of 18 simulation sessions were analyzed (Control: n = 9; InterFACE-AR: n = 9), involving 54 participants in total. Team leaders using the InterFACE-AR system had lower RTLX (mean difference [MD]: -15.0; 95% confidence interval [CI]: -27.0 to -4.6, p = 0.022) and Paas score (MD: -2.4; 95%CI: -3.6 to -1.4, p < 0.001), while documenting nurses showed similar reductions (RTLX -13.7, 95%CI: -26.7 to -0.4, p = 0.049; Paas -1.6, 95%CI: -2.8 to -0.1, p = 0.046) compared with those using PALS pocket card. Medication nurses demonstrated no statistically significant differences in RTLX (p = 0.098) or Paas score (p = 0.194). Teams using the InterFACE-AR system achieved significantly higher TEAM scores compared to those using PALS pocket card only (39.2 vs 35.8, MD: 3.4, 95%CI: 0.8 - 5.9, p = 0.030). CALM scores did not differ significantly between groups.</p><p><strong>Conclusion: </strong>Use of an AR-based decision support system during simulated pediatric cardiac arrest reduces workload and cognitive load for the team leader and documenting nurse, but does not affect workload or cognitive load of medication nurses. Use of the InterFACE-AR system seems to improve teamwork performance but does not influence leadership performance of team leaders.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov. Identifier: NCT06376643 .</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13281596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147824269","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":"Using co-design to create a fit-for-purpose debriefing framework for at-scale healthcare simulation.","authors":"Michelle A Kelly, David Freer, Lyn Gum","doi":"10.1186/s41077-026-00441-y","DOIUrl":"10.1186/s41077-026-00441-y","url":null,"abstract":"<p><p>It is widely acknowledged that debriefing within or following simulation-based education promotes reflection on and about practice. Resuming in-person simulations post-COVID-19 in our educational setting revealed that post-simulation debriefing was lacking. Given the large numbers of students and casual clinical educators we embarked on a project to reintroduce debriefing to simulation activities. While several frameworks exist to guide debriefing in clinical settings, approaches to debriefing undergraduate students in educational settings differ in intent and context and needs to align with local curricula and regulatory standards of practice. Acknowledging the substantial impact to teaching practices of this project, we used an educational co-design approach to maximise staff engagement, ownership and adoption of a local fit-for-purpose debriefing framework. We applied the 5 steps within the educational Connected Learning at Scale framework to project activities: explore/ideate; plan/design; build/test; implement/observe and reflect/evaluate. The aim of this paper is to provide details of the processes undertaken in developing an evidence-informed fit-for-purpose tool for use at-scale, engendering engagement and ownership, for context specific implementation. While developed with debriefing for simulation in mind, the localised, fit-for-purpose tool is flexible and appropriate to use for other university learning contexts.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13335274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147824275","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":"LIBRA: A simulation-based gender equality training programme for student leaders in higher education.","authors":"Michelle Kirrane Scott, Siobhán Lucey, Mide Power, Siobhán M Lucey, Claire Condron","doi":"10.1186/s41077-025-00404-9","DOIUrl":"10.1186/s41077-025-00404-9","url":null,"abstract":"<p><p>BACKGROUND: Training is required to build the capacity of future leaders to dismantle disadvantage, influence change and strengthen diversity and inclusion across higher education institutions. The LIBRA pilot project uses a novel simulation-based approach to equip student leaders with skills to address biases and promote gender equality. METHODS: Kern’s Curriculum Framework was utilised to systematically design a simulation-based gender equality training programme for students, employing a six-step approach that included problem identification, a comprehensive needs assessment using a mixed methods approach, and development of educational objectives and strategies. The LIBRA programme was piloted by 19 student leaders across two sites. The programme was evaluated by assessing participants’ pre- and post-event confidence to deploy skills and techniques which foster gender equity in post-secondary settings. Participant feedback was also collated via an online questionnaire. RESULTS: Students’ confidence in their ability to communicate, be actively aware and challenge gender equality matters increased post-intervention. They found the programme engaging, interesting, accessible, and relevant. Students felt comfortable participating in the training and found that the feedback provided to them was useful. The majority of students strongly agreed that simulation is a valuable approach to support the acquisition of gender equality competencies. CONCLUSIONS: Within the LIBRA pilot project, a simulation-based approach to tackling gender inequality was positively received by student leader participants. The LIBRA programme can be adapted for use in local contexts to create a co-operative simulated learning experience for participants. Further research is required to evaluate the impact and value of such training programmes within the context of wider Equality, Diversity and Inclusion (EDI) initiatives. </p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":"11 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13088561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700693","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":"Moulage safety practice around the world: a framework for best practice.","authors":"Jessica Stokes-Parish, Daniel Bauer, Cecile Fourie, Maritza Harvey, Samantha McCormack, Jyotsna Rimal, David Shablak, Naomi Shiner, Janice Sinoski","doi":"10.1186/s41077-026-00438-7","DOIUrl":"10.1186/s41077-026-00438-7","url":null,"abstract":"<p><p>BACKGROUND: Moulage is ubiquitous with simulated participant (SP) practice. Moulage presents a physical and psychological risk to SPs, due to the application of active products, ingredients, and the creation of highly realistic wounds, which could evoke emotional distress or overidentification. METHODS: The Moulage international Virtual Community of Practice convened in 2023 to commence standards of best practice in relation to moulage use with SPs. Using consensus methodology, the 9 authors catalogued their usual practice, reviewed relevant literature and standards to iteratively develop a conceptual framework and checklist. RESULTS: As a result, a conceptual framework and checklist were developed for safe moulage practice for pre-simulation, during-simulation, and post-simulation phases. The framework highlights key roles and corporate governance to achieve risk mitigation regardless of the simulation setting. To augment the framework, the authors developed the Moulage Application Safety Checklist, a 17-item tool for moulage in use. CONCLUSION: The conceptual framework and checklist provide an evidence-informed tool for considering moulage safety with SPs. Safe use of moulage should not be an afterthought. </p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13188686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147694027","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 might we interpret quantitative findings in simulation research more meaningfully?","authors":"Anders L Schram","doi":"10.1186/s41077-026-00437-8","DOIUrl":"10.1186/s41077-026-00437-8","url":null,"abstract":"<p><p>BACKGROUND: Quantitative findings carry particular authority in simulation research and are often read as decisive evidence that an intervention has—or has not—made a meaningful difference. Statistical significance can function as an interpretive shortcut, providing a ready-made storyline that compresses uncertainty and context. This debate article examines how such readings arise and why they risk exceeding what quantitative results produced in simulation research can legitimately be taken to support. MAIN BODY: The argument distinguishes what common statistical outputs are designed to show from what they are often asked to mean. A p-value describes how incompatible the observed data are with a no-difference model; it cannot by itself demonstrate learning or clarify how and why an observed contrast arose. In simulation research, this gap is often widened when samples are modest and when outcomes reflect behaviour that develops unevenly across clinical settings and over time. Under these conditions, interpretations that hinge on statistical significance alone become fragile. To make these limits explicit, the paper highlights four constraints on inference that clarify what a quantitative contrast can reasonably support: (1) uncertainty around the estimate, made visible through confidence intervals; (2) effect size understood in relation to variability and the conditions under which outcomes are produced; (3) the relevance of observed changes for clinical, organisational or educational work; and (4) the influence of systematic influences including information bias, selection bias, and confounding. A hypothetical emergency department resuscitation programme example illustrates how the same numerical contrast can support different conclusions once these constraints are taken seriously. CONCLUSION: Quantitative results remain central to simulation research, but they do not function as verdicts on whether an intervention worked. Their value depends on careful interpretation—treating statistical outputs as inputs to judgment rather than as decisive evidence. Making the constraints on inference explicit supports interpretations that remain proportionate to what the data can sustain and strengthens the development of cumulative knowledge in simulation research. </p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13188501/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679209","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":"On simulation, artificial intelligence, and the spirit of the Shokunin.","authors":"Ben Symon","doi":"10.1186/s41077-026-00435-w","DOIUrl":"10.1186/s41077-026-00435-w","url":null,"abstract":"<p><strong>Background: </strong>The healthcare simulation community has rapidly embraced artificial intelligence (AI) and large language models (LLMs) for scenario design, delivery, and debriefing. While discussions have largely centred on efficiency and academic integrity, less attention has been paid to the philosophical and humanistic costs of this integration. This commentary explores the potential erosion of identity, expertise, and craftsmanship within simulation as cognitive labour is increasingly outsourced to machines.</p><p><strong>Main body: </strong>Drawing on the Japanese concept of the Shokunin-the devoted artisan in lifelong pursuit of mastery-the commentary contrasts the Western drive for efficiency with the intrinsic value of patient diligence and deliberate practice. Using the life and reflections of artist Katsushika Hokusai as a metaphor for the simulationist's path, the author argues that expertise is cultivated through repetition, reflection and time-qualities at risk when AI automates creative and cognitive processes. The concept of cognitive debt is introduced to describe the deferred mental cost of repeated reliance on AI, including diminished critical inquiry and weakened creative ownership. To preserve the spirit of the Shokunin, three guiding principles are proposed: (1) Know the grain of your wood before you carve-protect formative manual and reflective work early in one's career; (2) Paint first with your own brush-prioritise original human creation before seeking AI feedback; and (3) Strive for personal growth-maintain curiosity and continuous growth as enduring antidotes to automation's complacency. These principles urge simulationists to use AI as a supportive partner, not a surrogate for expertise.</p><p><strong>Conclusion: </strong>AI will undoubtedly enhance simulation's technical capabilities, yet it also challenges our professional identity. To sustain meaning and mastery, simulation educators must intentionally preserve spaces for imperfection, repetition, and human creativity. The spirit of the Shokunin-humble, diligent, and ever-striving-offers a moral compass for navigating the evolving partnership between simulation and artificial intelligence.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":"11 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13072569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679203","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":"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/s41077-026-00436-9","DOIUrl":"10.1186/s41077-026-00436-9","url":null,"abstract":"<p><p>We offer a new interpretive framework to analyze and explain learning processes in real time during discursive interactions in clinical simulation, especially in debriefing. First, we question the computational metaphor of the mind, where the mind is conceptualized as a closed system that processes symbols linearly, typical of traditional cognitivist learning approaches with profound practical implications over debriefing. This approach is insufficient to explain the complexity of learning in situated, uncertain, and dynamic contexts such as debriefing. During debriefing, participants do not simply remember data or assimilate external conceptual structures ready to be used, but rather undergo more complex processes. They experience discontinuities, oscillations, and ambiguities in their thinking, while negotiating tensions and facing moments of cognitive and emotional instability. To capture this dynamic, we need a richer, more flexible, and more responsive approach to lived experience.Given these limitations, new interpretative proposals are emerging that seek to explain learning in debriefing by describing both the logic behind the configuration of the participants’ interpretive frames and the intra-subjective and intersubjective dynamics that modulate them in real time. The goal is to provide theoretical models that help us to elucidate a phenomenon that cannot be understood through linear schemes or unidirectional causalities, as it unfolds in the non-linear flow of brief temporal sequences loaded with meaning.To this end, we present a new interpretive framework in which we have integrated three fundamental theoretical concepts: liminality, microgenesis, and semiotic border. Although these concepts come from different theoretical traditions, we have united them in a conceptual framework that allows us to understand how frames of reference are configured during debriefing, without reducing them to fixed or pre-established conceptual structures, preserving their dynamic, contingent, and situated nature. Each of these concepts addresses, from different theoretical traditions, how meanings are constituted under conditions of structural instability and on very short time scales.Finally, we present empirical indicators that allow us to identify these complex and “elusive” phenomena in practice, providing guidance for supporting debriefers’ practice in noticing and interpreting learning, and a key methodological tool for research analysis as an emerging qualitative coding scheme.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":"11 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13067597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147655493","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":"Moving beyond projects: a logic model evaluation of an established translational simulation program.","authors":"Andrew Petrosoniak, Aradhana Tewari, Lindsay Beavers, Nivetha Chandran, Kristen Sampson, Christine Léger, Nazanin Khodadoust, Ryan Brydges","doi":"10.1186/s41077-026-00434-x","DOIUrl":"10.1186/s41077-026-00434-x","url":null,"abstract":"<p><p>BACKGROUND: Advancing beyond a sole focus on individuals’ and team’s clinical skills training, translational simulation uses simulation-based methodologies to diagnose healthcare system gaps and inform targeted quality and safety improvements. While promising conceptually, few reports exist on how to build sustainable, system-level translational simulation programs in hospital settings. METHODS: We applied a logic model evaluation framework to assess four-years of activity in Unity Health Toronto’s established translational simulation program. Researchers not directly involved in the translational simulation program interviewed internal team members and program partners who had utilized the program. The interviews focused on the processes associated with project selection, implementation, and outcome collection. The research team used an iterative, team-based consensus approach to develop a fulsome logic model to richly describe the observed impacts and challenges of the program. RESULTS: Our analysis reflected experiences of 10 internal team members, and 14 program partners who contributed to 11 completed projects. We found that early collaboration during project intake was critical, but sometimes slowed perceived progress. Program members described a regular need to establish a shared conceptual understanding and clear roles at the outset with each program partner. Mutual adaptability between the simulation team and partners was reported as a defining factor for successful project implementation. Program outputs primarily consisted of simulation team generated reports, which generally met partner expectations; however, several partners desired more detailed, actionable analyses. Mid- to long-term outcomes varied based on project goals, including changes to clinical workflows, policy revisions, improved team performance, and enhanced patient outcomes. CONCLUSIONS: Grounded in refined claims for each logic model element, this evaluation provides transferable principles and data-driven recommendations for implementing and sustaining translational simulation programs. Our findings informed local program refinements while also producing strategies that can be applied broadly to translational simulation programs: 1) Flexible engagement tailored to partner needs and context 2) Clear definitions of simulation modalities, milestones, roles, objectives, and deliverables, 3) Structured communication throughout all project phases, and 4) Consistent follow-up to ensure translation of insights into clear returns on investment, and sustained system change. </p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13170001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147610803","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}