Simulation
by drvictoriabrazil

Bridging Two Worlds: Human Factors and Translational Simulation in Healthcare

By:Victoria Brazil (@SocraticEM)

Healthcare simulation has long been an essential part of training clinicians and teams. But as the field matures, the simulation community is embracing a broader, more systemic use of simulation; extending beyond education into the design, testing and improvement of healthcare systems. This is the central theme of a recent Journal of Healthcare Simulation essay – Human factors and translational simulation: misunderstandings and potential opportunities. Dara Byrne, Paul O’Connor and Angela O’Dea make a compelling case for integrating human factors science with translational simulation to better understand systems, improve patient care and enhance staff working lives.

We know that healthcare is a complex sociotechnical system. Successful performance doesn’t depend solely on individual skills; it also rests on how people interact with tools, environments, tasks and each other. This systems view is one of the defining characteristics of human factors, the science that studies human interaction with other elements of systems to optimise performance, safety and wellbeing. But as the article authors point out, there is a widespread misconception that human factors is simply about human error or “non‑technical skills”. In truth, it is far broader: it’s about designing systems that support safe, efficient care and anticipate risk before harm occurs.

Translational simulation offers a powerful way to put human factors thinking into practice. Unlike traditional simulation-based education, translational simulation is purpose‑driven and system‑oriented. Its goal is to directly improve how care is delivered and how systems function. Rather than debriefing to assess learner performance, translational simulation debriefs to explore systems behaviours, uncover latent safety threats, test changes and generate actionable improvement recommendations.

On our Simulcast podcast interview with the authors, they emphasised how translational simulation can serve as a “safe lab” for systems testing. In a controlled environment, teams can trial changes to workspace design, clinical processes or equipment workflows without risking actual patient outcomes. This allows multidisciplinary teams to collect real‑time data, observe interactions, and refine approaches based on evidence rather than assumption.

Drs O’Connor, Byrne and O’Dea contend that the synergy between human factors and translational simulation is obvious but under‑exploited. Both disciplines aim to enhance the performance of complex systems, yet they often operate in parallel silos. Simulation specialists may use human factors language or tools when training teams, but without a deep understanding of human factors theory, they risk missing opportunities to diagnose system issues. Conversely, human factors practitioners may lack familiarity with simulation as a tool for systems evaluation and improvement.

For example, human reliability analysis – a human factors method used in high‑risk industries to examine task variability and error potential – can be integrated with simulation to develop or refine procedural guidelines that are grounded in real practice rather than hypothetical scenarios. Likewise, simulation can be used to assess whether medical devices are usable in real clinical contexts — an area where traditional regulatory testing often falls short.

Both the podcast and article make clear that better integration of these disciplines requires intentional effort, education and partnership. Simulation educators should deepen their understanding of human factors models, systems theory and sociotechnical approaches so that they can facilitate debriefs that probe beyond individual performance to reveal system dynamics. Human factors practitioners, on the other hand, should engage with simulation centres, attend simulation conferences and explore how simulation can extend their work from theory to practical system testing.

For simulation practitioners working to improve clinical environments this conversation has important implications:

  • Invest in knowledge: Strengthen your understanding of human factors principles to enhance how you interpret simulation data and translate findings into meaningful change.
  • Shift your framing: Think of simulation not just as a training event but as a tool for diagnostic system analysis and intervention.
  • Build multidisciplinary teams, beyond clinicians: Engage human factors specialists early in simulation design and debriefing to enrich insights and recommendations.

References

Photo – A Human Factors nightmare in the resus room  ( AI generated, but instantly recognisable…)

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