Distributed simulation--accessible immersive training.

Distributed simulation (DS) is the concept of high-fidelity immersive simulation on-demand, made widely available wherever and whenever it is required. DS provides an easily transportable, self-contained 'set' for creating simulated environments within an inflatable enclosure, at a small fraction of the cost of dedicated, static simulation facilities. High-fidelity simulation is currently confined to a relatively small number of specialised centres. This is largely because full-immersion simulation is perceived to require static, dedicated and sophisticated equipment, supported by expert faculty. Alternatives are needed for healthcare professionals who cannot access such centres. We propose that elements of immersive simulations can be provided within a lightweight, low-cost and self-contained setting which is portable and can therefore be accessed by a wide range of clinicians. We will argue that mobile simulated environments can be taken to where they are needed, making simulation more widely available. We develop the notion that a simulation environment need not be a fixed, static resource, but rather a 'container' for a range of activities and performances, designed around the needs of individual users. We critically examine the potential of DS to widen access to an otherwise limited resource, putting flexible, 'just in time' training within reach of all clinicians. Finally, we frame DS as a 'disruptive innovation' with potential to radically alter the landscape of simulation-based training.