Healthcare teams are often asked to “prove the value” of simulation. Too often we default to pyramids and hierarchies of outcomes, and return on investment spreadsheets. These methods can miss what really matters and the intended learning outcomes of the simulation . Value-Based Simulation in Healthcare (VBSH) reframes the conversation. It’s a taxonomy, not a hierarchy. It’s designed to match your evidence to your stakeholders and context.

Journal Club Article: Barker, L., Meguerdichian, M., Walker, K., Janssens, S., Szabo, R., Lopez, C., Henricksen, J., & Symon, B. (2025). Value-based simulation in healthcare: a new model for metrics reporting. Advances in Simulation, 10(1).

The VBSH “pie” (six slices, no ranking)

• Service Products – the operational “what, who, how” (courses run, participants, time, space). Often the quickest way to show delivery against plan or accreditation needs.
• Program Perceptions – purposeful feedback from learners, leaders, funders, consumers. Subjective—but valuable for adoption signals (e.g., confidence to use a new process).
• Acquired Expertise – verified learning with defensible assessments (checklists, teamwork scales, mastery thresholds), not self-ratings.
• Workplace Performance – implementation and system learning: what changed in the clinical environment, and what simulation uncovered about “work as done.”
• System Benefit – tangible and intangible impacts aligned to the quintuple aim (patient experience, population health, cost, staff wellbeing, equity).
• Value Analyses – cost-aware questions (“Was it worth it for the spend?”). Return on investment is one option—use it when budgeting decisions hinge on dollars, not by default.

Why it works

• Relevance over rank: stop chasing “higher levels”—select slices that answer the sponsor’s real question.
• Smarter measurement: avoid burning time on tenuous outcome data; collect fewer, higher-yield measures tied to purpose.
• Better storytelling: report a coherent, decision-ready narrative (outputs delivered → how it was received → what teams got better at → what changed at the bedside → any system-level benefits → costs when appropriate).

Bottom line: Value in simulation isn’t a race up a pyramid—it’s a context-rich story told with the right slices of data for the job.

Additional Reading

Brazil, V. (2025). Value-based simulation in healthcare: shifting from metric power to metric relevance. ICE Blog.