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Beyond the training: Outreach Simulation and Systems Change

By: Victoria Brazil (@SocraticEM)

We’ve all felt the awkward pause in the conversation: “So… how do you know your sim program improves patient outcomes?” It’s the uncomfortable moment when good intentions collide with the reality of measurement. The STORK team in Queensland has given us a better answer. Not by chasing the holy grail of patient-level impact, but by turning the focus squarely onto systems.

I recently recorded a podcast with Ben Symon and the STORK crew, who walked us through their approach – measuring what simulation actually changes in the clinical environments it touches. Their outreach program delivers paediatric resuscitation education across regional Queensland. But this isn’t just about teaching. It’s about diagnosis and intervention. Think simulation as Trojan horse: education on the surface, but underneath – systems probing, safety audits, and quality improvement seeds planted.

Their 2025 publication in Advances in Simulation outlines a deliberately pragmatic strategy. Forty courses. 242 system issues identified—mostly around equipment, processes, drug safety. Nearly half resolved, with many more still in progress. No randomised control trial, no breathless claims—just credible, local, trackable change.

Crucially, they’ve wrapped this in a systematic process. It’s not a dashboard or a KPI tracker—it’s a reporting mechanism that actually lands. Short, narrative summaries sent to the right people: ED directors, execs, educators. It closes the loop between what happens in sim and what happens in real clinical work. Simple, but rarely done.

This is translational simulation in its clearest form, not defined by location (in situ vs centre-based), but by function. As I wrote in 2017, it’s not “where?” but “why?”. The “why” here is unmistakable: use simulation to fix what’s broken, not just teach what’s ideal.

None of this works, though, without the right people running the show. Faculty development for translational sim needs to look very different. These aren’t just good debriefers. They’re QI-literate, systems-savvy, politically aware operators who can navigate the ward, the simulation space and the realities of health systems

A few reflections for those of us running programs:

References

St-Onge-St-Hilaire, A., Lawton, B., Dodson, L. et al. Outreach simulation for system improvement: a novel advocacy and reporting process. Adv Simul 10, 44 (2025).

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