What question did this study set out to answer?

To explore the experiences of clinically active ambulance clinicians participating in high-fidelity simulation.

July 5, 2026Advances in Simulation0 citationsOpen Access

Exploring realism in high-fidelity ambulance simulation: ambulance clinicians’ perspectives on correspondence with everyday practice

WKWivica KauppiUniversity of Borås MHMagnus Andersson HagiwaraUniversity of Borås HSHanna Maurin SöderholmLindholmen Science Park

Key Points

To explore the experiences of clinically active ambulance clinicians participating in high-fidelity simulation.
Qualitative design with dyadic interviews of 16 ambulance clinicians involved in simulation scenarios.
Data analyzed using inductive content analysis as per Elo and Kyngäs.
Participants noted the necessity of mental readiness for effective involvement in simulations.
While scenarios were perceived as realistic, achieving complete psychological fidelity was challenging due to awareness of the simulation setup.
Carefully designed scenarios that enhance psychological presence can improve engagement and reflect real-world practices.

Abstract

Abstract Background High-fidelity simulation (HFS) provides a controlled environment for training, allowing ambulance clinicians’(ACs) to practice and refine their skills without risking patient safety. Additionally, it enables the replication of complex scenarios, ensuring comprehensive preparedness for real-life emergencies. However, there remains a need to understand how frontline professionals in ambulance services experience these simulation-based activities. This is especially true when using high-fidelity modalities that aim to replicate real-world scenarios for research purposes. Aim To explore clinically active ACs´ experiences of participating in HFS. Methods A qualitative design involving dyadic interviews with 16 ACs participating in a simulation scenario was conducted. The data were analyzed using the inductive content analysis method outlined by Elo and Kyngäs. Results Participants emphasized the importance of adopting the right mindset from the start of the scenario, as mental readiness was crucial for immersion. Although the scenario felt realistic, achieving full psychological fidelity remained challenging, as participants’ awareness of the simulation setup influenced their behavior during the scenario. Conclusions The study underscores the importance of carefully designed HFS scenarios that prioritize psychological and environmental fidelity to support authentic engagement among clinically active ACs. This is particularly important in pre-hospital care, where direct access to real clinical situations is often restricted by ethical, practical, and organizational constraints. The findings indicate that well constructed simulations with coherent workflow sequences, professional actor–based patient representation, and realistic settings can function as a methodological bridge for capturing complex cognitive and emotional processes that are otherwise difficult to study in real world practice. Further refinement of simulation design, focusing on psychological presence rather than complete physical or technical realism, may strengthen simulation-based research as a method for investigating experiential aspects of pre-hospital care.

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