Translational Simulation in healthcare setting

What is Translational Simulation?

Translational simulation is utilized to uncover and mitigate both latent and active risks that jeopardize patient care and efficiency of service delivery (Clipperton, et al., 2024). It integrates systems engineering and risk management principles into the complex adaptive healthcare systems through consistent, collaborative, and iterative simulation-based activities. Translational Simulation can be conducted in-situ or within traditional simulation centres (Brazil, 2017).

The term ‘translational simulation’ originates from the field of biological science where ‘translational’ pertains to applying basic scientific research to practical applications, embodying a bench-to-bedside approach (Brazil & Reedy, 2024). This approach encourages biomedical researchers to focus on clinical application aiming to enhance the health of patients and populations.

Simulation Methodologies in Healthcare

Healthcare simulation methodologies encompass the use of manikins, cadaver-based simulations, and role-playing. Other techniques include tele-simulation, computer-based simulations, tabletop exercises, data modelling, and virtual reality settings (Cristina, et al., 2023).

Role and Potential of Translational Simulation

While educational outcomes are significant, they do not fully reflect the potential of translational simulation to enhance healthcare outcomes (Brazil, 2017). Beyond education, translational simulation also performs diagnostic and interventional roles. It tests healthcare system processes and procedures, evaluates performance, and provides insights for system design and improvements. Moreover, it encourages development of better team cultures, communication and enhance work environments. Translational simulation can also be tailored to address specific purposes, such as implementing massive transfusion protocols or enhancing professional conduct within teams (Brazil & Reedy, 2024).

Aligning with Healthcare Organisations’ policies and priorities

For translational simulation to be effective, it must be integrated into an organisation’s clinical governance and quality improvement frameworks (Brazil, et al., 2022). Participation of simulation program leaders in organisational quality and safety management is essential.

How?

It is recommended for organisations to develop policies that foster simulation to take place (Brazil, et al., 2022). This can be achieved by establishing a steering group, which is vital for developing and implementing a simulation safety policy, involving key stakeholders for advice and approval. Highlighting the benefits of existing simulation programs and fostering staff participation are important. Incorporating required practices into accreditation processes are necessary. Clear communication about the purpose of simulation is vital, as is enabling faculty to conduct safe and effective simulation sessions is vital.

Why is psychological safety important in conducting translational simulation? 

Psychological safety builds the foundation of simulation as it encourages participants to step out of their comfort zones and demonstrate their usual practice. This allows learning points and the differences between ‘work-as-imagined’ and ‘work-as-done’ to be identified in debriefing sessions. In such a secure environment, individuals are also motivated to discuss clinical reasoning and uncertainties that are often left unaddressed in daily practice. When participants feel safe from judgment regarding their clinical knowledge and performance, they are more likely to adopt learning-promoting behaviours such as seeking feedback, discussing errors, and experimenting new approaches (Madireddy & Rufa, 2023). 

How? 

Strategies are recommended by Madireddy and Rufa (2023) to build a psychologically safe environment for translational simulation, some of which are included in the following. One of these is familiarising participants with the case scenario, physical environment, and equipment. It is also essential to conduct pre-briefing sessions to emphasise that the aim of translational simulation is not to test individual responses and abilities but to assess system performance. Facilitators are recommended to reinforce that confidentiality must be maintained by faculty and participants during discussions outside of simulation sessions. Cognitive load and human factors should be considered during the design of the simulation to prevent information overload for participants.

Reference: 

Brazil, V. (2017). Translational simulation: not ‘where?’ but ‘why?’ A functional view of in situ simulation. Adv Simul 2, 20. https://doi.org/10.1186/s41077-017-0052-3.

Brazil, V., Reedy, G. (2024). Translational simulation revisited: an evolving conceptual model for the contribution of simulation to healthcare quality and safety. Adv Simul 9, 16. https://doi.org/10.1186/s41077-024-00291-6.

Brazil, V., Scott, C., Matulich, J., et al. (2022). Developing a simulation safety policy for translational simulation programs in healthcare. Adv Simul 7, 4. https://doi.org/10.1186/s41077-022-00200-9.

Clipperton, S., McIntosh, L., Janssens, S., & Symon, B. (2024). Designing a faculty development programme for systems-focused translational simulation.

Cristina, D. N., Robert, A., Matthew, C., et al. (2023). Global consensus statement on simulation-based practice in healthcare. Simulation in Healthcare, 10-1097.

Madireddy, S., & Rufa, E. P. (2023). Maintaining confidentiality and psychological safety in medical simulation. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK559259/.

Nickson, C. P., Petrosoniak, A., Barwick, S., & Brazil, V. (2021). Translational simulation: from description to action. Advances in simulation (London, England), 6(1), 6. https://doi.org/10.1186/s41077-021-00160-6.