Perceptions and learning continue to evolve over time. This HealthySimulation.com article by Michael Collier, CHSOS, Simulation Operational Specialist at Froedtert and the Medical College of Wisconsin, shares his personal experience and insights into how he gauges learner success after ten years of working in medical simulation. “Changing one’s mindset is rarely easy. Perspective, personality, and experience often shape, and sometimes limit, how we view the world. In healthcare simulation, I’ve found that continual self-reflection is essential, not only for learners but also for those of us who support and design their training.” After more than nine years as a Simulation Operations Specialist, he recently experienced a true “ah-ha” moment. Over the course of supporting thousands of learners through hundreds of simulations, his views on learner performance and judgment have gone through several stages of evolution.
Stage 1: The Newcomer’s Lens
When first hired into the simulation operations role, everything is new. Personal impressions of whether learners had performed “well” were underdeveloped, often shaped by the reactions and feedback of subject matter experts (SMEs) and educators. At that stage, the simulation operations specialist may be more focused on not making mistakes myself than on critically analyzing learner performance. In truth, Michael was in awe of both learners and faculty, quietly absorbing the experience.
Stage 2: Ownership and Investment
As confidence is gained and the simulation operations specialist becomes more involved in scenario design, perspectives shift. Michael had developed a deeper clinical understanding and a stronger grasp of simulation methodology. Running the same scenario dozens of times with different learners provided sim ops with a wide view of outcomes and an acute awareness of errors.
Inside the control room, the healthcare simulation professionals who designed and facilitated simulations often knew the “right answers” and the “ideal script.” As a result, their pride swelled when learners executed scenarios flawlessly, and disappointment crept in when things diverged. The personal investment in the process, the sweat equity, sometimes caused us to equate success with perfection.
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Stage 3: A Broader Realization
Over time, the healthcare simulation professional can see that these scenarios were never about the healthcare simulation professionals or the team. They were, and always will be, for the learners. The healthcare simulation team’s role is not to judge, but to create an environment where participants can grow.
From personal experience, Michael has heard, and even thought at times, comments such as:
- “I hope I never code on their unit.”
- “Well, that was a mess.”
- “Hopefully this next group does better than the last one.”
Not until recently has Michael more deeply reflected on the implications of those remarks. If every learner performed flawlessly and every scenario went exactly to script, there would be no need for simulation. The value of what we do lies precisely in the chaos, the missteps, and the unexpected moments. That is where the richest learning occurs.
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Understanding Success Differently
Michael recently supported a series of scenarios for a group of learners that combined standardized participants (SPs) with a manikin. The final scenario involved a medical emergency with the manikin as the patient. From the control room, the session looked like chaos. Critical steps were missed, interventions were performed incorrectly, and the flow of care unraveled.
Afterward, one of the SPs, who had remained professional and in character throughout, remarked, “Hopefully tomorrow’s group is a little more organized. If this had been a real patient, they wouldn’t have made it.”
But that was exactly the point. The experience was not with a real patient. These learners had the rare opportunity to manage a crisis in a safe space, one where a mistake would not cost a life. There were no real-world consequences: no grieving family, no lingering guilt, no emotional scars carried back to the workplace. Instead, what they experienced was practice: a chance to struggle, to identify gaps in knowledge and skill, and to learn without fear of irreversible harm.
At that moment, Michael was reminded that not everyone shared the same definition of success as related to how learners perform in simulation. What looked like “failure” on the surface was, in fact, success. The scenario provided learners with the opportunity to grow, to build confidence, and to return better prepared for real clinical challenges.
Embracing Imperfection as Opportunity
Michael states, “I have come to view imperfection not as failure, but as opportunity. Each deviation provides a chance to coach, reassure, and build confidence. Our role is to uncover the why behind learner actions, to understand their intent, and to use those insights to guide growth.”
Healthcare Simulation must remain a safe space, not a stage for judgment, but a lab for learning. If learners feel safe enough to show up authentically, to try their best, to be vulnerable in front of peers, facilitators, standardized patients, and clinical simulation staff, that reflects well on us as educators and operations specialists. If they do not, that reflects on us too.
Final Reflection of Reflection for the Healthcare Simulation Team
Their performance is not a reflection of you. Their effort is not a reflection of you. But the learning environment you create, the safety, trust, and encouragement that you cultivate, absolutely is.
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