High-fidelity simulation continues to evolve and expand year to year in healthcare education. Since the 2020 COVID-19 pandemic, healthcare simulation has doubled in size globally and is expected to continue growing at around 15% annually. Within that growth, wearable simulators remain a small but rapidly accelerating niche, one that has gained recognition for their realism and the measurable improvements they bring to learner outcomes. A new study, โ Effect of AvTrach Wearable Airway Simulator versus High-Fidelity Manikin on Tracheostomy Suctioning Competency and Physiological Stress: A Multi-Institutional Randomized Controlled Trialโ, published in 2025, dove into the cortisol (stress) levels of student learners using either a traditional manikin or the Avtrach Wearable Airway Simulator. This HealthySimulation.com article highlights the results of this research study, where the results might surprise you!
Bringing Humanity Back to Healthcare Simulation
During Healthcare Simulation Week 2025, Avkin CEO, Amy Cowperthwait, CEO, RN, MSN, CNS, CHSE-A, sat down with WDELโs Peter MacArthur to discuss how wearable simulators are transforming healthcare education. In the conversation, Amy shared the inspiration behind developing technology that bridges the gap between technical training and authentic patient interaction, highlighting new research proving Avkin simulators reduce learner stress and boost confidence. The interview underscored a simple truth: bringing humanity back into simulation changes the way future nurses and clinicians learn, and ultimately improves patient care. View the flipbook of the Avkin Del-Aware interview:
Without wearables, learners miss a patientโs voice, emotional responses, and real-time feedback. Avkinโs wearable simulators allow learners to look someone in the eye, practice procedures on a live actor portraying human emotions, and receive verbal and non-verbal feedback, creating a deeper form of immersion.
Avkin is one of the worldโs primary wearable simulator manufacturing companies, so be sure to visit Avkin at IMSH 2026 Booth #1229 in San Antonio, Texas this January!
Simulation Participants Demonstrate Decreased Cortisol Levels with Wearables
Amy also highlighted a groundbreaking multi-site study with Johns Hopkins and the Durham VA Hospital. The findings were clear: students trained with wearable simulators demonstrated steadier stress levels and stronger performance when entering real patient care compared to learners trained on manikins. Cortisol testing confirmed what simulationists have long suspected: realistic, human-centered training not only builds technical competence but also protects learnersโ cognitive performance under pressure.
Manikin-trained learners achieved a median competency score of 30. Those trained with the Avtrach wearable simulator scored 34, a statistically significant improvement. Cortisol markers told the same story: With the transition into clinical care, the manikin groupโs median cortisol rose to 0.38, while the wearable group held a steadier 0.22. The wearable simulator did not just help learners perform better, the wearable simulator helped the learners stay physiologically composed under pressure, which is precisely where clinical performance often breaks down. In other words, learners trained with Avtrach not only performed better, but they remained physiologically composed during real-world stress, where performance often falters.
View the HealthySimulation.com Realistic Trach Training: Enhancing Clinical Skills with Wearable Trach Simulators Webinar to learn more!
The Why Behind the Cortisol Levels Research Results
Avtrach merges physical, conceptual, and psychological fidelity to create an immersive learning environment that reinforces emotional engagement and skill mastery. Below is an episode of Simulation Nation with Dr. Vinciya Pandian, one of the researchers behind the recently published AvTrach study. In this episode, Dr. Pandian goes in-depth about the study and the results they found firsthand.
โWe measured their salivary cortisol,โ Pandian pointed out in the interview, โ…and when they transitioned into real patient care as wellโฆ the wearable simulator group maintained more stable cortisol levels instead of spiking like those trained on traditional mannequins.โ
According to Pandian, this research paves the way for future PhD-level inquiries, specifically concerning the longevity of these advantages and methods for assessing long-term outcomes for learners.
View the new HealthySimulation.com Community Standardized Patient / Simulated Patient Group to discuss this topic with your Global Healthcare Simulation peers!
From Local Roots to Global Impact with Avkin Wearables
Finally, Amy shared how Avkinโs journey began at the University of Delaware with support from engineering, business, and health science partners. What started as a local collaboration has grown into an international movement, with Avkin devices now used all over the world to improve patient safety and workforce readiness. The message is clear: by putting humanity at the center of healthcare training, wearable simulators are not just advancing simulationโฆ they are transforming the future of patient care.
More About Avkin
Avkin is a manufacturer of wearable devices for use in healthcare simulations and is a consultant for standardized patient programs. Founded by a nurse educator, Avkin provides a simulation solution that combines the best of high-fidelity mannequins and the realism of standardized patients for the most authentic simulation experience possible. The company believes that the key to success in patient-centered care is practitioner training through realistic healthcare simulations and that human interaction is irreplaceable in clinical education. Avkin Wearable Simulator Products Include:
- Avbirth, Fully-Automated, Wearable Birthing Simulator
- Avtrach, Wearable Tracheostomy Simulator
- Avstick, Wearable IV Insertion Simulator
- Avline, Wearable Central Line Simulator
- Avtone, Wearable Heart & Lung Sounds Simulator
- Avcath, Wearable Catheterization Simulator
- Avthor, Wearable Chest Tube Simulator
- Avwound, Wearable Wound Simulator
- Avband, Wearable Patient Cueing Device
- Elite Simulation Package
- Manikin Replacement Package
- Vital Signs Package
Be Sure to Visit Avkin at IMSH 2026 Booth #1229!
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