Innovation Spotlight: The MSF Field Simulation Program
The contexts where MSF’s teams are providing medical-humanitarian services are often volatile, uncertain and complex. Planning and practising for different eventualities in the abstract can be both difficult and inefficient.
This is where simulation comes into play. Simulation is a method for increasing preparedness and strengthening capacity in a safe environment, with room for trial and error.
This article looks closer at what the field of simulation encompasses and how it can be used in humanitarian contexts. It also provides an overview of the MSF Field Simulation Program, which aims to promote and support the use of simulation across MSF.
The visual shows the areas where simulation is currently being used by MSF.What is simulation?
In a nutshell, simulation is about modeling a real-life or hypothetical situation in a controlled environment. Simulation mechanisms are being widely used by humanitarian actors for a variety of reasons, from improving the efficiency of supply chains, to crisis management, capacity building, and for team development exercises.
What is the MSF Field Simulation Program?
Launched in late 2018, the Field Simulation Program aims to promote and support the use of simulation across MSF. Since the launch of the program, the Field Simulation team has offered simulation trainings and support to MSF colleagues working in medical areas, ranging from nursing to pediatrics, and sexual and reproductive health, to non-medical areas such as emergency response, security, and logistical challenges.
“[During simulations] you have a safe environment, it is very motivational, participants participate in the discussions, you find an environment where you can talk about your errors without a sense of being judged [...]. You use mistakes and errors as a way to learn.”
The Field Simulation Program is centered around three main pillars:
Supporting simulation capacity building across MSF: the program team provides training and coaching to staff working in different roles at a project level to equip them with the tools and knowledge required to make efficient use of simulation and run their own simulations.
Embedding simulation into MSF operations: the program aims to increase uptake of simulations across MSF by promoting the use of simulation mechanisms in a variety of contexts.
Explore and innovate new methods and use cases for simulation in MSF: to help MSF teams tackle new challenges head on, the Field Simulation team takes a flexible and reflective approach, working to adjust its training tools and processes to MSF’s ever-changing circumstances
Under pilar 1, the Field Simulation Program team offers training to so-called local facilitators, these are MSF staff working at a project level who are equipped to lead simulation sessions in their projects. Over 60 local simulation facilitators were trained across 13 projects as part of the program between 2019 and 2023. During the same time, more than 1,500 simulations with close to 5,000 participants were organised across a number of countries, including Cameroon, Burkina Faso, Mali, Nigeria, and Yemen.
The purpose of the simulations organised has included:
Practice and strengthen diverse skills, including security simulations on how to react to security incidents like checkpoints or armed robberies, simulations of communication skills to practice giving bad news, simulations to be better prepared during infectious disease epidemics such as Ebola, Malaria, Covid-19 and much more.
Identifying systemic issues and exploring opportunities to improve our ways of working, including testing and evaluating existing emergency response plans, as well as care plans for survivors of sexual assault and violence.
Simulation case - Yemen: One example of an MSF project where simulation was used can be found in Alqanawis, Yemen. The focus of this simulation intervention was capacity building for staff working in the newly established pediatrics department, at the Mother and Child hospital. Five local facilitators, including three doctors and two nurses, were trained in using simulation methods. They then went on to organise a “Pediatric Emergency Training” simulation exercise with close to 30 participants. During the session, participants practiced the ABCDE approach (short for “Airway, Breathing, Circulation, Disability, Exposure”, a triaging method) as well as response plans for common critical conditions among pediatric patients, including respiratory problems, convulsions, dehydration, and shock. A subsequent evaluation more than 90 percent of the participants expressed that they found the simulation exercise useful.
In the coming year, the MSF Field Simulation program is going to provide new training opportunities and build capacity in simulation through the continuous development of diverse simulation scenario packages for MSF staff around the world, while exploring new and innovative applications in the medical-humanitarian context.
This photo was taken during a pediatric simulation exercise in Yemen, 2023. 
This image shows a debriefing after a simulation exercise in Pulka, Nigeria, 2021.
This image shows a tabletop simulation exercise to analyze the triage circuits in Bobo, Burkina Faso, 2023.