Training for the Unexpected: Simulation in Medical Education 

In the high-stakes world of medicine, preparation can mean the difference between life and death. As medical education evolves, educators are increasingly turning to simulation training—a dynamic, hands-on approach to teaching clinical skills, decision-making, and communication. These realistic practice scenarios allow learners to experience complex medical situations in a safe environment before encountering them with actual patients.

“Simulation has really changed the way that health care providers learn, practice, and achieve competency,” says Andrew Eyre, MD, MS-HPED, an emergency medicine physician and medical director of the STRATUS Center for Medical Simulation at Brigham and Women’s Hospital. Eyre is a long-time faculty member in the Training to Teach in Medicine program, where he helps participants explore how to thoughtfully integrate simulation into curricula.

For generations, clinical training followed a familiar formula: see one, do one, teach one. But as Eyre explains, that model has serious limitations. “You’re at the whim of whatever happens to come through the door that day. With simulation, learners can get hands-on training in a safe environment. They can make mistakes without consequences to real patients. It creates deeper connections to the material and much more engaging learning.”

Building a New Learning Landscape

The use of simulation in health care education has expanded significantly over the past 20 years, driven by advances in technology and a deeper understanding of how people learn. Educators explore a wide range of teaching methods, from traditional lectures to flipped classrooms, but simulation stands out for its ability to create immersive, memorable experiences.

“One of the things we try to convey is that simulation is a tool—just like a textbook or software,” Eyre explains. “It’s not the solution to every teaching problem. But when it’s selected and implemented thoughtfully, it has tremendous value.”

That careful integration is a key theme throughout the program. “We really want participants to think about when simulation is the right choice,” he says. “It’s not about having the newest gadgets. It’s about getting learners out of passive modalities and into interactive, hands-on education.”

More Than Just Mannequins

While high-tech mannequins and sophisticated equipment often steal the spotlight, Eyre is quick to point out that effective simulation doesn’t require a massive budget. “You can do high-quality simulation with low-cost materials. We still make many of our own models—using things like gelatin and balloons,” he says. “It’s about creativity and purpose, not just expensive tools.”

At the same time, innovations in virtual reality (VR) and augmented reality (AR) are expanding access and opportunities. “There’s a real shift toward more immersive environments,” says Eyre. “With a VR headset and an internet connection, you can simulate an operating room, an ICU, or a mental health clinic. You can practice procedures, make diagnoses, and even engage in full conversations with virtual patients.”

This kind of simulation is becoming more common across all health care fields—not just emergency medicine. “Ten years ago, only a couple of companies were doing this,” Eyre says. “Now it’s everywhere. It started with nursing, but now it’s used across the spectrum, including surgery, internal medicine, and psychiatry.”

Patient Safety and Systems Improvement

Simulation doesn’t just prepare individuals—it also strengthens teams and systems. At Brigham and Women’s Hospital, Eyre and his team use simulation for both skill-building and quality assurance. For example, they’ve developed a training program for placing central lines—long IVs that carry the risk of infection. “We require every provider to come to the simulation center and demonstrate sterile technique before doing it on patients. It’s not about replacing faculty oversight; it’s about ensuring a safe baseline.”

They also conduct surprise drills to test emergency preparedness—similar to fire drills in schools. “We simulate a medical emergency somewhere in the hospital without warning,” he says. “We’re not just testing whether people know what dose of medication to give. We’re testing whether the alarms go off, if security knows what to do, if people can access equipment quickly. It’s about testing the entire system.”

Simulation is also used in response to near misses or safety concerns. “If something almost went wrong, we’ll run a reenactment and figure out what needs to change. We collaborate closely with our quality and safety team to continuously improve,” Eyre says.

Global Reach, Local Adaptation

For Eyre, working with learners serving a range of economic settings reinforces an important message: simulation is scalable. “You don’t need a million-dollar lab to do this well. We try to dispel the myth that simulation equals high cost,” he says. 

With a basic headset and software, a classroom in any country can be transformed into a trauma bay, an outpatient clinic, or a psychiatric evaluation room. “You’re not just watching a video—you’re inside it,” Eyre explains. “And the systems can now grade you, track your performance, and even use AI to simulate realistic conversations.”

The Future of Simulation

Still, Eyre cautions against viewing simulation as a complete replacement for real-world experience. “This is a step in education, not the final destination,” he says. “You still need mentorship, feedback, and real patient encounters. But simulation provides consistency and repetition that help learners build confidence and competence.”

He also warns against overreliance on expensive technology. “The tendency is to invest in a product without thinking about how to use it. That’s why we emphasize educational goals first. The question is always: What are you trying to teach, and what’s the best way to teach it?”

Ultimately, Eyre believes that simulation succeeds because it creates experiences that stick with learners. “If I ask students to describe a moment when they really learned something, almost no one mentions a lecture. They talk about a moment, a feeling, an experience,” he says. “Simulation helps us create those moments deliberately—so people learn more deeply and remember more clearly.”

In Eyre’s view, simulation allows one to move from passive to active learning.  It’s about creating safe opportunities for learners to make mistakes, solve problems, and reflect on what they’re doing. “That’s how we train for the unexpected—and prepare the next generation of health care professionals.”