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Simulation appears to work most effectively when it is designed to meet curricular outcomes, includes realistic and relevant content, interesting and engaging learning methods and prepares learners for working in the clinical context in terms of activities, skills and competencies (Issenberg et al, 2005).

The key element here is building simulation activities into learners’ progression

There is a consistent association between the amount and the quality of deliberate practice and performance in domains as varied as chess, music and sport (Ericsson and Charness, 1994). Deliberate practice means that there is effort involved as well as some form of feedback, whether through self assessment, from the simulator or observation by another person.