Healthcare simulation has significant potential for helping health services to deal with the COVID-19 pandemic. Rapid changes to care pathways and processes needed for protection of staff and patients may be facilitated by a translational simulation approach-diagnosing changes needed, developing and testing new processes and then embedding new systems and teamwork through training. However, there are also practical constraints on running in situ simulations during a pandemic-the need for physical distancing, rigorous infection control for manikins and training equipment and awareness of heightened anxiety among simulation participants. We describe our institution's simulation strategy for COVID-19 preparation and reflect on the lessons learned-for simulation programs and for health services seeking to utilise translational simulation during and beyond the COVID-19 pandemic. We offer practical suggestions for a translational simulation strategy and simulation delivery within pandemic constraints. We also suggest simulation programs develop robust strategies, governance and relationships for managing change within institutions-balancing clinician engagement, systems engineering expertise and the power of translational simulation for diagnosing, testing and embedding changes.

In the clinical setting, simulation is emerging as an important educational technology for learning about contemporary clinical care. The aim of this case study was to illustrate the feasibility of simulation as a research translation mechanism. Designing and delivering a simulated learning activity for delirium prevention was a key implementation strategy in a larger study focused on translating research evidence into practice. Using evidence about delirium prevention, and in collaboration with key stakeholders, the simulation team developed a delirium prevention scenario that was conducted four times with nurses in the participating ward. This study suggests that the use of simulation design and delivery as a research translation mechanism is feasible. Based on this experience, further research into how simulations can function as research translation mechanisms is recommended, with a view to improve patient outcomes through supported practice change.