“What if we’ve had simulation training wrong all along?” For years, many of us — in healthcare, police, military, and emergency services — have assumed the same thing: The more realistic the simulation, the better the learning.
More technology. More realism. Better mannequins. More immersive environments.
But what if that assumption is fundamentally flawed?
In my recent podcast conversation with emergency physician, anthropologist, and simulation researcher Eve Purdy, one idea kept challenging my thinking:
“Real doesn’t necessarily mean more learning or better.”
And perhaps even more surprising:
“We have seen people behave more like it’s real life with the laminated cutouts than with things like mannequins.”
Yes — laminated paper patients.
That conversation led us into a fascinating exploration of simulation training, team stress, learning transfer, psychological safety, and why teams sometimes perform brilliantly under pressure — while other times they fall apart.
About Eve Purdy
Eve Purdy is an emergency physician with a background in anthropology and a strong passion for understanding how teams function under pressure. Trained in both emergency medicine and anthropology in Canada, she now lives and works in Australia.
At Gold Coast Health, she works as an emergency physician and leads simulation-based team training. She is also affiliated with the Translational Simulation Collaborative, where her work combines frontline clinical care, anthropological insights, and systems thinking to improve how healthcare teams learn, collaborate, and perform.
In addition, she is currently building Simulation Simplified — an initiative focused on creating simple yet powerful tools that make team training more accessible and practical, wherever healthcare happens.
Her mission is clear: helping teams work and learn better.
Topics
Introduction to Eve Purdy
Emergency medicine, anthropology, simulation, PhD on team stress
PhD research: Team stress in emergency medicine
Individual stress vs team stress
Shared appraisal of stress
Resuscitation teams and acute stress
Example of team stress in practice
Pregnant trauma patient scenario
Stress contagion vs calming effects within teams
Can team stress be measured?
Challenges of measuring team stress
Quantitative vs qualitative approaches
Stress mapping and reflective interviews
Connection to CRM (Crew Resource Management)
Observable behaviors vs underlying psychological processes
Stress as an explanation for adaptive and maladaptive team behaviors
What simulation actually is
Simulation as an active learning experience
Reflection and shaping real-world practice
Realism in simulation questioned
High fidelity vs low fidelity
Why realism does not necessarily improve learning
Engagement and immersion over technology
Introduction to translational simulation
Individual learning vs team learning vs system improvement
Simulation aimed at systems, environments, and processes
Examples of translational simulation
Resuscitation room layout
Improving workflows and equipment access
Diagnostic vs intervention-focused simulation
Why translational simulation is growing
Shift from education-only mindset
Links with quality improvement
Transfer mechanism of simulation training
Reflection-on-action
Why healthcare teams struggle with debriefing
Why debriefing often does not happen
Time pressure
Team performance culture
Practical barriers
How to improve transfer to practice
Weekly emergency simulation programs
Social learning and trust building
Familiarity and teamwork effects
Discussion of Self-Determination Theory
Motivation, competence, autonomy, relatedness
Theoretical frameworks for understanding performance
Systems change vs training individuals
Why redesigning systems can outperform training
Introduction to Simulation Simplified
Eve’s new initiative
Simple simulation tools
Visually Enhanced Mental Simulation (VEMS)
Laminated patients and equipment
Low-tech simulation in practice
Why simple simulation works
Mental imagery and imagination
“Pretend as if” learning
Comparing laminated patients to mannequins
The problem of realism
The “too close to reality” problem
Comparison with VR and uncanny realism
Role of the simulation facilitator
Trust and engagement
Anticipatory cueing
Facilitation skills
Complexity and multiple facilitators
Large team simulations
Participant engagement
Applications beyond healthcare
Military
Police
Aviation
Disaster response
Team-based mental simulation
Good briefing and debriefing
Matching simulation to objectives
Circular questions
Team reflection
Systems-focused debriefing
Anthropology and healthcare
Why Eve studied anthropology
Team culture in hospitals
Functional vs dysfunctional teams
Psychological safety and belonging
Feeling included vs excluded
Impact on contribution and performance
Hospital tribes and team cultures
Emergency department culture
Departmental differences
Fault lines in healthcare teams
Smash teams and temporary teams
Teams forming quickly under pressure
Dynamic team structures in healthcare
Team rostering and familiarity
Stable teams vs random scheduling
Trust, belonging, and improvement
Key lessons for simulation
Importance of clear objectives
Matching modality to goals
Simpler may work better
Book, podcast, and learning recommendations
Teams That Work
The Culture Code
Simulation podcasts and resources