Stress test

But how can we balance the effectiveness of simulation with the safety of students in an increasingly remote world?

“Simulation environments are proven to be far more effective and engaging for students than sitting back to watch a YouTube video of the same technique,” says Principal Matthew Todd, who has designed simulation spaces for UNSW, University of Newcastle, and University of Wollongong among others. 

And while simulation training has traditionally been the realm of medicine and aviation, new tech is causing a revolutionary expansion in its use. “AI Avatars are providing the key area for growth,” explains Associate Principal Jeroen Hagendoorn. “So far, simulation has mostly been based on gaining experience in interacting with certain equipment in a specific environment. But simulated human avatars open a whole new field of opportunities based around interactions, from practicing how to handle a difficult class of students to diplomatic negotiations.”  

But, as Jeroen explains, universities have the responsibility and unique opportunity of providing not only the latest tech and their own modules, but also the physical and psychological scaffolding to ensure students can learn in a safe, supported environment that ensures the simulated experience will have pedagogical value. “The key to a good simulation is that it’s immersive as an experience,” says Jeroen, who’s worked on next generation teaching spaces with Monash University and the University of Melbourne.

For designers, creating a space where students can be observed but not feel observed is crucial. At the UNSW Health Translation Hub, simulation wards for medicine, physio and pharmacology students are linked to adjacent classrooms, enabling half the class to observe while the other half is in the simulation. Built-in AV and IT allow for recording and reviewing simulations, while the flexible design leaves room for students and educators to enter the simulation together, and for future adaptation.

Features of the HTH Simulation Spaces 

• Acute & critical care replication: includes two single-bed simulation rooms designed to replicate an emergency department or critical care unit. 

• Diverse learning environments: beyond emergency rooms, the space features dedicated acute care areas, general ward settings, and private consultation rooms. 

• Simulation pharmacy: a practice dispensing environment featuring a virtual dispensary and counter. Sessions can be live-streamed to a larger briefing room so entire cohorts can observe and analyse student-patient communication. 

• Specialised labs: the hub includes custom skills laboratories, a teaching gym, virtual reality (VR) teaching hubs, and a blood collection facility. 

Simulation spaces, which include fixed physical rooms to fully virtual environments and everything in-between, are now being used to train skills from remote team crisis management to offshore wind turbine repair and concussion-safe tackling. Across the spectrum of use, high-stress environments remain the common denominator. “We are training people’s frontal cortex – learning to do the right thing when experiencing a fight or flight moment,” says Jeroen. 

Pairing immersion with nearby human support is crucial, especially in potentially emotional, high-stress simulations such as paramedic training. At the Victoria University Centre of Excellence in Paramedicine, a mix of augmented reality, immersive projection and hybrid simulation spaces are all paired with adjacent ‘reset rooms’, providing support and a chance to debrief directly after experiencing high-pressure scenarios such as transferring critical patients from an ambulance to an emergency department. 

Giving learners the opportunity to process their experience with the support of a teacher is critical. “When people are in a really intense simulation, they can have a genuinely traumatic experience,” says Jeroen, who emphasises the difficulty of providing the right kind of support for remote learners.  

“In a tertiary environment, you can build the scaffolding that supports students before and after the experience. Imagine a young student at home wearing a headset, being screamed at by an avatar – what happens when they take off the headset? What was the value of that distressing experience and what will they learn from it?” 

Within the UNSW Health Translation Hub, control rooms sit adjacent to simulation wards, so mannequins and room conditions can be adjusted in real time. This means educators can help students immediately to re-enter reality. 

“This is a state-of-the-art experiential learning environment,” says Principal Matthew Todd of the Clinical Skills and Simulation Centre, located on the second level of HTH. Matt, who led the HTH project team, says the vital difference is in how the space expertly mimics precise medical environments. “It bridges the gap between classroom theory and real-world hospital practice.”  

Jeroen argues that the ideal simulation ‘bookends’ immersion with human interaction. “To maximise usage of your investment, it makes sense to brief and debrief your students in adjacent spaces and free up the actual simulation space for the next group of students,” says Jeroen. 

 At the Broadmeadows Health and Community Centre of Excellence (HACCOE), multiple different simulation environments support nursing, pathology, disability support and early childhood education students. The VR Immersion Gallery features a double-height room with a 360° projection screen, plus sound and temperature control and retractable seating. 

 “Large-scale simulation spaces allow students to feel completely immersed, but they can still turn to their peers to read their face and body language – something you can’t do with avatars in VR,” says Jeroen. 

Each simulation platform has its own strengths and focus areas, from familiarising students with specific spaces and equipment, to honing their skills in challenging environments and encounters.  

Phil Worth, an emergency department consultant in Melbourne, says medical students feel empowered when they are involved in designing the scenario they will take part in. “Simulation spaces create an opportunity to get buy–in from the student.” 

Phil argues that ultimately, simulation training goes beyond an individual’s skills.