We sat down with Dr. Victoria Brazil to discuss how simulation can serve as a powerful tool for improving healthcare systems. Watch the video or read the transcript below.

Dr. Victoria Brazil

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

When healthcare organizations use simulation at its very best, what does success actually look like to you?

Dr. Brazil: “Success looks like great patient experience. It looks like safe care. It looks like effective care. It looks like care that is accessible. And it looks like care that the providers enjoy and do well.

I think that’s success from an organizational point of view and from the community’s expectations point of view. Simulation has contributed to that in lots of different ways over the years, but I think it can realize its potential when we start really thinking about those targets and thinking about the systems that help us.” 

You’ve often spoken about simulation as a way to improve systems, not just individual performance. What changes when organizations truly embrace that mindset?

Dr. Brazil: “What changes is that we bring quality improvement to the frontline care providers. And the word we sometimes use is, we ‘democratize’ quality improvement.”  

“All of these are really important processes for us to think about. And these organizations change from thinking about simulation as only a tool for the education and training of the healthcare professionals as a way to make their work easier, better, faster, so that they can actually deliver the care better. 
 
And this is a systems focus as opposed to an individual practitioner focus for the simulation programs within those health services.” 

What role does curiosity play in effective quality improvement—and how can simulation help organizations cultivate more of it?

Dr. Brazil: “Curiosity in this space is about organizational learning and being curious about, what’s the real problem here? Because as a clinician myself, I know the mindset that is very quick to leap to: ‘I think the problem is simple. We should just do this to fix it.’ And I think sometimes in quality improvement, we jump in too early. What simulation allows us to do is to recreate these challenges.

Curiosity in this instance is about organizational learning and thinking about taking that curiosity to what actually ails us in the healthcare system.  

As clinicians, sometimes we’re quick to leap into fixes and solutions without really understanding the problems that we’ve got.  

So if we think about simulation as a place where we recreate a lot of our patient care encounters and we get to explore them—because we can do this over and over, we can do it on demand, we can do it with different groups of health care providers…we get a much richer understanding. We bring much more volume of curiosity to the table.  

And it means that we don’t jump in to create solutions that just might not be fit for purpose, and that haven’t been tested with those frontline clinicians involved.” 

In your experience, what do high-performing teams learn about themselves when they use simulation to test ideas before changing real-world care?

Dr. Brazil: “I think most of all, they learn that they can be part of the improvement solution. And unfortunately, sometimes we feel very disempowered in health care. I think when they go through this process of using simulation to improve, what they do is they suddenly think, ‘I can be part of this. My voice matters here, and I’ve got a method by which it can be not just heard, but also gathered together with other voices, analyzed, and actually turned into actionable insights that the organization can use.’

So I think teams discover that they can be part of the solution, and they do discover some things about themselves. Unfortunately, most of us are fallible humans—and what we think we do is not always what we actually do.” 

How can simulation help healthcare organizations move from “doing projects” to building a culture of continuous improvement?

Dr. Brazil: “A culture of continuous improvement is something that healthcare organizations aspire to. They talk a lot about it. And I think simulation is a tool that can help shift there. Certainly we do see bounded projects. Sometimes they work.”  

“And to help people with the methodological expertise that we have as simulation professionals to help both identify the problem, work on simulations to explore the problem, and to test solutions. And then ultimately, to provide information in the form of wisdom and actionable insights that we can actually do, that then lead from one improvement to the next improvement, and the next one.  
 
And that’s the culture you’re talking about.” 

If you could offer one piece of advice to organizations starting to use simulation for quality improvement, what would help them get the most value early on?

Dr. Brazil: “This is a challenging task to run effective, helpful simulations for quality improvement purposes. So I think any practitioner needs to get help. I think we need an internal team. I think we need good relationships with the quality and safety within our own institutions. But we would also say, I think they need tools.  

And the kind of tools that we’ve been developing can help people, end-to-end, think about their translational simulation design, think about their delivery, and help in the gathering of data and processing of that data.

So I think those practitioners need tools to help them. And they probably also need some education to help them. So some short courses, some of which we’re developing in line with those tools, and some of which are available elsewhere. But I think getting help, collaborating, and having good tools.”