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Using clinical simulation to study how to improve quality and safety in healthcare
  1. Guillaume Lamé,
  2. Mary Dixon-Woods
  1. THIS Institute (The Healthcare Improvement Studies Institute), University of Cambridge, Cambridge, UK
  1. Correspondence to Dr Guillaume Lamé, THIS Institute (The Healthcare Improvement Studies Institute), University of Cambridge, Cambridge CB2 0AH, UK; guillaume.lame{at}


Simulation can offer researchers access to events that can otherwise not be directly observed, and in a safe and controlled environment. How to use simulation for the study of how to improve the quality and safety of healthcare remains underexplored, however. We offer an overview of simulation-based research (SBR) in this context. Building on theory and examples, we show how SBR can be deployed and which study designs it may support. We discuss the challenges of simulation for healthcare improvement research and how they can be tackled. We conclude that using simulation in the study of healthcare improvement is a promising approach that could usefully complement established research methods.

  • simulation-based research
  • research methods
  • healthcare improvement research
  • clinical simulation
  • quality of care

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See:

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  • Contributors MD-W had the original idea for the paper and both authors developed the content. GL surveyed the literature and wrote the first draft of the paper, and MD-W adapted and revised this draft. Both authors approved the submitted version.

  • Funding GL and MD-W are supported by the Health Foundation’s grant to the University of Cambridge for The Healthcare Improvement Studies (THIS) Institute. THIS Institute is supported by the Health Foundation, an independent charity committed to bringing about better health and health care for people in the UK. This work was also supported by MDW’s Wellcome Trust Investigator award WT09789. MDW is a National Institute for Health Research (NIHR) Senior Investigator.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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