Educational principles in Tabletop Simulation: an overview

Tabletop simulation (TTX) has emerged as an innovative educational tool within medical training, offering a unique approach to experiential learning. By simulating real-world scenarios, TTX allows learners to practice skills and make critical decisions in a low-risk environment. Traditionally associated with disaster preparedness and emergency response, TTX has now expanded into various non-emergency applications, demonstrating broad potential across healthcare domains. TTX’s structured yet flexible format allows for the enhancement of cognitive and interpersonal skills, such as communication, leadership, and teamwork, through collaborative gameplay. This paper explores the current state of TTX, its educational principles, and its strengths and limitations. It provides up-to-date evidence-linked insights for educators and facilitators. Key essay themes include: 1) the role of prior learner knowledge and ability to facilitate learning, 2) specific motivational theories identifiable in current TTX games, and 3) the current state of TTX debriefing. Within this work, several impressive, peer-reviewed studies linking TTX to educational practice are identified, and key underlying learning processes that can and should be exploited in TTX are explored. Overall, there is a clear trend towards developmental progression in the field of TTX on both commercial and home-grown levels. However, we find the current body of work is lacking and systematic work needs to be done in order to develop a coherent evidence base.