Evidence Shows Translational Simulation Improves Patient Outcomes and Organizational Performance

Translational simulation goes beyond education and skills training—it directly enhances clinical performance and strengthens healthcare systems. Supported by growing evidence across multiple care settings, it empowers frontline teams to identify, test, and refine processes that lead to measurable improvements in patient safety and organizational outcomes.

“We cannot ‘policy’ our way to excellence. Too often, healthcare organizations respond to challenges by adding more policies and rules. But excellence doesn’t come from binders full of procedures. Instead it comes from the frontline staff providing care.”1  

- Dr. Andrew Petrosoniak MSc (Med Ed), FRCPC, 
Emergency Physician and Trauma Team Leader at St. Michael’s Hospital in Toronto, Canada

Andrew

Connecting Simulation to Outcomes

Translational simulation isn’t just about skills practice. It's built to analyze, refine, and enhance systems of care, ultimately driving better patient outcomes. But what does the evidence actually show? A growing body of literature is demonstrating that these simulation-based interventions can deliver measurable benefits across outcomes—at both the patient and organizational levels.

Evidence from Translational Simulation Research

 

Simulation Science: From Skill to System

A comprehensive review by McGaghie and colleagues traced the progression of simulation-based medical education (SBME) from lab-based learning, through improved care delivery, all the way to enhanced patient and public health outcomes. They found that structured, ongoing SBME translational science yields concrete downstream improvements and positive return on investment.2

 

Functional Definition and Practice Framework

Translational Simulation experts Dr. Chris Nickson and Dr. Victoria Brazil define translational simulation as simulation driven by diagnosing safety issues and implementing solutions within real systems. Their framework—used in over 1,000 activities across Australia and Canada—reinforces how simulation serves diagnostic, interventional, and embedded improvement roles.3

What Has Translational Simulation Achieved So Far?

Real-world studies reveal several concrete outcomes that speak loudly in an environment where policies and rules have often been the “go to” to accomplish change:

 

  1. Better Cardiac Arrest Survival (In-Hospital, Pediatric)
    A clear association was demonstrated between the frequency of in situ mock codes and improved survival rates for in-hospital pediatric cardiac arrests. Hospitals with higher mock code participation translated their efforts into significantly better outcomes by being more familiar with the systems in which they had to perform.4

  2. Reduced Stroke Treatment Delays
    Simulation-led protocol revision in a Norwegian stroke center slashed door-to-needle times for thrombolysis, enhancing the effectiveness of stroke care. Front line workers used simulation to identify needed changes and put those changes into practice.5

  3. Faster Trauma Care Delivery
    Studies in translational simulation show that trauma patients receive blood transfusions more quickly, spend less time in the trauma bay before CT scanning, and benefit from higher task completion rates and improved teamwork. Rather than focus on individual skills, front line workers used simulation to identify system shortcomings and then test and improve system changes.6

  4. Improved Pediatric Airway Safety
    In pediatric critical care, simulation interventions led to better airway management, with increased compliance to the U.S. National Emergency Airway Registry for Children (NEAR4KIDS) safety bundle in the PICU. Again, front line staff used simulation as a tool for systems refinement.7

  5. System Redesign and Space Planning
    Translational simulation has been used by front liners to identify latent safety threats, test solutions, and orient staff during new clinical space openings—like hospitals, obstetric units, EDs, and emergency response teams—ensuring smoother initiation and safer operations.8

  6. Cultural and Systemic Transformation
    Qualitative research highlights that translational simulation fosters improved hospital culture—including enhanced communication, shared goals, and mutual respect. This describes stronger organizational performance, not just individual competence. And it is the breakthrough that many in hospital leadership are seeking.9

  7. Rapid Health Service Transformation (COVID-19 Response)
    During the COVID-19 pandemic, translational simulation played a pivotal role in transforming hospital and system-wide procedures—particularly in maternity services and pandemic preparedness—helping teams adapt faster and safer. This was accomplished not through imposed rules and guidelines but through simulation efforts on the ground floor.10

 

 

“Anyone involved in healthcare knows that no matter how good our individuals are, or even how good our teams are, we ultimately fall or rise to the level of our systems. …We don't just simulate to see if people can do something; we simulate to see what in the system stops them from doing it.”11 

Dr. Victoria Brazil

Director, Bond Translational Simulation Collaborative; Professor of Emergency Medicine and Director of Simulation, Bond University

Dr Victoria Brazil circle

What This Means for Healthcare Leaders

 

Key Insights

  • ✓
  • Translational simulation moves learning from knowing to doing—and improving—as a system.
  • ✓It has demonstrated improvements in survival rates, reduced treatment times, team coordination, and care, all while being responsive enough to guide rapid transformations.
  • ✓It also contributes to culture change—making learning visible, systemic, and sustainable.

 

Implementing Translational Simulation

While we would recommend taking an informed and formal approach to translational simulation, that should not hold you back from some of the basic steps you can take to begin.

 

1

Define Clear Goals
Target real-world care outcomes (like survival, timeliness, safety).

2

Use Evidence-Based Models
Apply frameworks like diagnostic, interventional, or embedded simulation cycles, and consult us at Laerdal for guidance.

3

Set Performance Metrics
Track response times, adherence to protocol, or outcomes—not just simulation completion.

4

Engage Stakeholders Broadly
Involve clinicians, quality teams, and safety officers from the start.

5

Iterate and Scale
Use insights to refine systems, policies, or spaces, then test again through simulation.

Key Takeaway

 

Translational simulation isn’t just about learning—it’s about improving care systems. The evidence shows it delivers tangible clinical benefit, systemic improvement, and cultural transformation. It’s the difference between knowing what to do—and having a system built to support doing it well.

 

Learn More

Translational Simulation is about giving the experts on your staff the tools to create an expert environment in which they can perform. Policies and rules are convenient, but they rarely match the sticking power of using simulation as a quality improvement tool. Start using it to redesign care that works better for patients and the teams who serve them.

Ready to rethink your next QI initiative? Contact us to explore further how you can start with simulation.

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References
  1. Petrosoniak, A. (2025). We cannot policy our way to excellence. Linkedin.com. https://www.linkedin.com/posts/andrew-petrosoniak_we-cannot-policy-our-way-to-excellence-too-activity-7372252700660412416-LTUw/
  2. McGaghie, W. C., Draycott, T. J., Dunn, W. F., Lopez, C. M., & Stefanidis, D. (2011). Evaluating the Impact of Simulation on Translational Patient Outcomes. Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare, 6(7), S42–S47. https://doi.org/10.1097/sih.0b013e318222fde9
  3. Nickson, C. P., Petrosoniak, A., Barwick, S., & Brazil, V. (2021). Translational simulation: from description to action. Advances in Simulation, 6(1). https://doi.org/10.1186/s41077-021-00160-6
  4. Josey, K., Smith, M. L., Kayani, A. S., Young, G., Kasperski, M. D., Farrer, P., Gerkin, R., Theodorou, A., & Raschke, R. A. (2018). Hospitals with more-active participation in conducting standardized in-situ mock codes have improved survival after in-hospital cardiopulmonary arrest. Resuscitation, 133, 47–52. https://doi.org/10.1016/j.resuscitation.2018.09.020
  5. Nickson, C. (2022, May 5). Translational Simulation. Life in the Fast Lane. https://litfl.com/translational-simulation/
  6. Ibid.
  7. Ibid.
  8. Ibid.
  9. Ibid.
  10. Ibid.
  11. Sautter, M. & Egeland, B. (Hosts) (2023, January 20). Can Patient Simulation be Used for Continuous Improvement? (No. 2) [Audio podcast episode]. In One Million Lives Podcast. Laerdal Medical. https://laerdal.com/us/information/one-million-lives-podcast/