As new technologies, such as electronic medical records (EMRs), are introduced into healthcare services, we need to consider how they may be incorporated into simulated environments, so as to maintain and enhance authenticity and learning opportunities. While EMRs have revolutionised clinical practice, many education settings continue to rely on paper-based documentation in simulation, creating a widening gap between educational environments and real-world clinical workflows. This disconnect limits learners’ ability to engage authentically with the tools and resources that underpin contemporary healthcare, impeding the transfer of knowledge to the clinical environment. This practice-based commentary draws on institutional experience from a large, multi-disciplinary simulation-based education facility that explored approaches to integrating EMRs into simulation-based education. It describes the decision points and efforts made to integrate an EMR into simulation-based education and concludes that while genuine EMR systems increase fidelity, their technical rigidity and data governance constraints reduce authenticity. To overcome this, Adelaide Health Simulation adopted an academic EMR (AEMR), a purpose-built digital platform designed for education. The AEMR maintains the functional realism of clinical systems while offering the pedagogical flexibility required to control data, timelines, and learner interactions. Drawing on this experience, this commentary highlights how authenticity in simulation-based education is best achieved not through technological replication alone, but through deliberate use of technologies that align with clinical realities while supporting flexible, learner-centred design. Purpose-built AEMRs exemplify how digital tools can enhance both fidelity and authenticity, fostering higher-order thinking, clinical reasoning, and digital fluency essential for safe and effective contemporary healthcare practice. Here, we argue that advancing simulation-based education in parallel with health service innovations is required if we want to adequately prepare learners for contemporary clinical practice.
Jolly et al. (Thu,) studied this question.