And how is it different from traditional applications of simulation?
Traditionally, simulation has focused on improving individual knowledge and team skills. Translational simulation goes further—using simulation as an active tool to diagnose problems, improve systems, and design safer, more effective care.
- Dr. Victoria Brazil
Director, Bond Translational Simulation Collaborative; Professor of Emergency Medicine and Director of Simulation, Bond University
Simulation in healthcare has long been seen as a powerful tool for education. From training students in basic clinical procedures to preparing teams for rare emergencies, simulation has helped build competency, confidence, and muscle memory.
But healthcare’s greatest challenges today aren’t always due to individual knowledge gaps—they stem from system-level complexity, communication breakdowns, and workflow inefficiencies.
That’s where translational simulation enters the picture.
Coined by Dr. Victoria Brazil and adopted by experts like Dr. Andrew Petrosoniak, Christopher Peter Nickson and others, translational simulation refers to the use of simulation not only to teach better care practices, but to improve care systems. It acts as a bridge between frontline practice and system design, helping teams test ideas, expose risks, and embed safer ways of working.
Citing how simulation is widely adopted for healthcare education and training, Dr. Victoria Brazil points out that simulation can be taken a step further by and being "connected directly with health service priorities and patient outcomes, through interventional and diagnostic functions, independent of the location of the simulation activity".2
You can think about it this way: translational simulation “translates” the efforts of simulation into better “care structure”, i.e., better systems outcomes:
Translational simulation enables healthcare teams to:
In other words, translational simulation doesn't just ask, "Do our clinicians know what to do?" It asks, "Does the system help them do it?" When people think of simulation, they often think of education and training (what to do), and leave out improving the environment in which they do it (the system itself).
- Dr. Andrew Petrosoniak MSc (Med Ed), FRCPC,
Emergency Physician and Trauma Team Leader at St. Michael’s Hospital in Toronto, Canada
At St. Michael’s Hospital, Dr. Petrosoniak led a translational simulation effort to test the layout of a new trauma bay before construction was finalized.
Simulations revealed equipment placement that impeded communication, poor visibility of monitors, and movement barriers for staff. Based on those insights, the team redesigned key features—before the space opened to patients.
The result? A safer, more functional trauma environment grounded in lived experience—not assumptions.
In Nebraska, a simulation program across 12 rural hospitals revealed gaps in obstetric hemorrhage response—particularly around blood availability, medication location, and team coordination.
Through in situ simulation, staff identified flaws, redesigned their emergency response protocols, and practiced repeatedly.
— OB/GYN physician, Bryan Health
This is translational simulation in action: diagnosing the gap, co-designing the solution, embedding it through practice, and validating it in the real world.
According to QI experts and generally accepted best practices, translational simulation efforts typically follow two pathways:
A simulation designed to function like a "systems diagnostic test," helping participants and others understand how things currently work and where risks or problems lie.
A simulation designed to test and practice solutions and improvements and ensure that any changes are to the benefit of better patient care and system performance.
According to Dr. Victoria Brazil, “The term translational simulation describes healthcare simulation focused directly on improving patient care and healthcare systems, through diagnosing safety and performance issues and delivering simulation-based intervention, irrespective of the location, modality or content of the simulation. It offers a functional alignment with quality improvement activities in healthcare institutions, while encompassing those educational interventions [that target] practice behavior or patient outcomes.” 6
Translational simulation doesn’t replace traditional education—but it moves simulation closer to the real work and focuses squarely on improving system performance and outcomes.
If you're already running a simulation program, here are the steps to evolve it toward translational impact:
Involve Stakeholders Beyond Education
Bring in quality leads, frontline staff, facilities, and patient safety officers. The goal is to affect care, not just competence.
Start in the Real Environment
Run in-situ simulations in the units, rooms, or workflows you want to improve. Observe everything: team dynamics, equipment, delays.
Make System-Level Debriefing Routine
Instead of just asking "What did the team do well?" ask, "What broke in the process? What helped or hindered?"
Track Outcomes
Go beyond participant confidence. Look for changes in response time, near-miss reports, latent threats resolved, or patient outcomes.
Share the Wins
Publish your findings. Even small improvements—like better IV access kits or streamlined NICU handoffs—can inspire big changes across systems.
Traditional simulation trains people. Translational simulation transforms systems. Both are valuable—but translational simulation will give you a whole new level of gains.
If you’re ready to enter the systems improvement arena and start a new path toward shaping safer care, it’s time to go translational.
