July 6, 2023By Eric Ayers

How to Use Design Thinking to Enhance Healthcare Simulation: Part 1

Design Thinking is a human-centric problem-solving process that allows for quicker results and the ability to test and modify at an accelerated speed. A new buzz word in multiple industries including healthcare simulation, Design Thinking can help clinical simulation teams to improve the performance of their simulation programs over time, through a reiterative review process which provides for consistent feedback cycles over time. This HealthySimulation.com article will be the first of two articles written by Eric Ayers, MBA, BSN, which will focus on Design Thinking to share ways the methodology can enhance healthcare simulation. The second article is now available here: How to Use Design Thinking to Enhance Medical Simulation: Part 2. Check out Eric’s previous articles Healthcare Simulation for Process Improvement and How Healthcare Simulation Enhances Communication and Organizational Culture for great primers on the topic.

Design Thinking: Knowledge and Process

To understand how Design Thinking may play a crucial role in the enhancement of healthcare simulation, the simulation team must understand what Design Thinking is and the steps involved within the process. Design Thinking began in the creative design industry. The human-centric aspect of the Design Thinking process houses the potential power within the outcomes. Think of this approach as solving the right problem the first time, which leads to improved efficiency, effectiveness and productivity.


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The healthcare simulation team offers many modalities that build the realism and authentic environment. When members of the simulation team are included in internal meetings, they bring value and different perspectives to the needs assessment. This involvement positions the simulation team to identify and begin work to mitigate the actual problem from a systems-approach.

Design Thinking is displayed as linear, however the true application of the process is cyclical in nature. The key steps are:

  • Empathy
  • Define
  • Ideate
  • Prototype
  • Test

The cyclical nature of the process is important because at any point in the process, the users can go back and test to ensure the process continues to meet the actual need. Even when finished and launched, the process can be modified and edited based on the new evolutionary needs within the organization.

Empathy: Empathy begins the process to understand the ‘who’ or persona behind the problem being solved. The healthcare simulation team must know who they are solving the issue for prior to the introduction of innovative ideas and systems. Empathy maps, for example, are great tools that allow the healthcare simulation team to see the world through the persona’s eyes. This crucial first step also brings in the humanistic aspect to the problem solving process. A focus on empathy creates a different feel from a typical process improvement or project management some healthcare simulation professionals are accustomed to.


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Define: Once the ‘who’ is identified, the healthcare simulation team can then identify the ‘what’ needs to be solved. Tools such as The Five Whys offer a great way to examine the causes of a problem so as to be able to diagnose the root cause and eliminate the surface-level side effects. Time spent on this step creates more impactful outcomes for the steps to follow. This is also a great place for the healthcare simulation team to get more insight from the others within the organization, which will assist in identification of the root cause. Spend adequate time here.

Ideate: Now that we have designed the ‘who’ and ‘what’ of our needed simulation activities, next we need to explore a list of potential solutions. As with all things Design Thinking, there are various brainstorming tools. The Really Bad Ideas template and brainstorming activity is a great one to begin with. The Really Bad Ideas activity offers those involved with the opportunity to rapidly tap into their creativity and quickly bring the group together. This leads to both a more focused ideation session and better ideas to brainstorm. Better ideas equals better results.

Prototype: Once the ideas are identified and organized, construction begins with the best concept alignment to build a prototype to solve the problem. Examples of prototypes include simulating a new patient care area prior to actual patient care, or a container with supplies available for clinical simulation use to inform simulation developers of available resources. The prototype can address process issues with the development and implementation of a policy or guideline for the organization.

With a prototype identified, the innovators and early adopters are able to provide a visualization of the solution for the late adopters and laggards, and foster early change adoption. A prototype allows the healthcare simulation team the ability to show their solution to those affected instead of only within a presentation, which aligns with the healthcare simulation modality of “doing” or actioning the proposed solution as a means of progression.

Test: How does the healthcare simulation team know that the proposed solution met the objective if the simulation is not tested first? Pilot tests are crucial for system-wide change because the validation must be evident, otherwise the momentum could decrease rapidly. The healthcare simulation members can identify a small target group within this process improvement that would impact their day-to-day operations and then pilot test the simulation.


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The testing step can be completed in-situ or in the simulation center, whichever makes more sense for the initiative. The important aspects within this phase are to see the potential solution in action, get valuable feedback from the utilization of the new solution, and clients, if applicable. An example of pilot testing a new process on Central Venous Line (CVL) dressing change could include an observed dressing change on a patient with a CVL for years and understands the process, or in the simulation lab with an evaluation checklist . Data can be collected by the healthcare simulation team observing, the nurse that performed the procedure and the patient that the procedure was performed on, or the skills validation checklist.

Once this data is obtained, if any discrepancies are noted, the healthcare simulation team can now take the new information and go through the process again. The beauty lies in the new knowledge that the healthcare simulation specialists have identified as well as the ability to interject the newfound information into the specific step to meet the objective.



For example, if the end user was misidentified, then a revisit to Empathy would make sense. However, if the steps were misaligned, then the Ideate and/or Prototype step might be more beneficial. Once the final process is in place, the healthcare simulation team will have a jumpstart on the process the next time their Quality Department reaches out in regards to a potential problem within the organization.

Design Thinking possesses the potential to create a system-wide approach to process improvement, while simultaneously capitalizing on the healthcare simulation team’s attributes. Incorporating Design Thinking into the daily operations of healthcare simulation offers permission for the organization to work together as they move forward into a human-centric approach to problem solving.

Up Next Part 2: Design Thinking for Communication and Organizational Culture

Eric’s second article How to Use Design Thinking to Enhance Medical Simulation: Part 2, dives deeper into the specifics behind how Design Thinking can enhance healthcare simulation, provide examples of improving communication and organizational culture, and the fun that is incorporated within the process.

Learn More Process Improvement in Clinical Simulation


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