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2 November 2025

Latvia’s National Strategy for Simulation-Based Healthcare Education

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1
Medical Education Technology Centre, Rīga Stradiņš University, LV-1067 Riga, Latvia
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The Faculty of Social Sciences, Rīga Stradiņš University, LV-1007 Riga, Latvia
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Governance Office, Rīga Stradiņš University, LV-1007 Riga, Latvia
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Authors to whom correspondence should be addressed.
Educ. Sci.2025, 15(11), 1465;https://doi.org/10.3390/educsci15111465
This article belongs to the Special Issue Technology-Enhanced Nursing and Health Education
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Abstract

This policy insight outlines Latvia’s national strategy for integrating simulation-based education into all levels of medical and healthcare education by 2027. It is framed as a direct response to the 2024 Global Consensus Statement on Simulation-Based Practice in Healthcare, operationalizing its recomme ndations within a national policy context for Latvia. Grounded in international and national standards—including WHO guidance, EU directives, and principles of healthcare safety and education quality—the strategy promotes simulation as a transitional and indispensable phase between theoretical instruction and clinical practice. The strategy emphasises structured collaboration among universities, professional associations, healthcare providers, and government bodies. It sets out a governance and resource model for simulation-based learning environments, ensuring quality, sustainability, and alignment with ethical and professional standards. By embedding simulation-based education into undergraduate, postgraduate, and continuing medical education, Latvia aims to enhance healthcare professionals’ clinical competence, reduce preventable medical errors, and improve patient outcomes. The approach supports deliberate practice, facilitates safe and realistic training conditions, and strengthens the preparedness of healthcare workers for both routine and complex clinical scenarios. The strategy also calls for standardised quality-assurance mechanisms, accreditation procedures, and integration into national regulatory frameworks. This national roadmap aims to establish Latvia as a regional leader in simulation-based healthcare education, improving not only the safety and efficiency of healthcare services but also public trust and professional development. As such, the strategy serves both as a practical implementation plan and a model for countries pursuing similar goals.

1. Introduction

Ensuring high-quality and safe healthcare requires a well-educated, competent, and confident workforce. In response to global challenges and the growing demand for effective healthcare services, Latvia has prioritised the integration of simulation-based education into medical and healthcare training. Simulation offers a structured, safe, and ethically sound learning environment where students and professionals can develop, refine, and assess both technical and non-technical skills without putting patients at risk. This approach aligns with international strategies and policy frameworks—including the WHO Global Strategy on Human Resources for Health and EU directives on patient safety and professional qualifications—highlighting the essential role of education in strengthening health systems and improving patient outcomes.
Following the cooperation memorandum signed on 7 December 2023 by the Ministry of Health of the Republic of Latvia, Rīga Stradiņš University, University of Latvia, the Latvian Medical Association, the Latvian Junior Doctors Association, the Latvian Nurses Association, the Latvian Union of Professional Organisations of Medical Practitioners, and the Emergency Medical Service—titled “National Strategy for the Development of Simulation-Based Education in Medical and Healthcare Education”—the document “Strategy for the Development of Simulation-Based Education in Medical and Healthcare Education in Latvia” (hereinafter referred to as the Strategy) has been developed.
The development of this Strategy acknowledges the importance of integrating a simulation-based approach into medical and healthcare education, as well as reflects the commitment of the Strategy’s development partners to collaborate and involve a broader range of stakeholders. This effort aims to enhance the quality of education for current and future professionals in the medical and healthcare fields, as well as to improve the quality of healthcare services, encompassing aspects of safety for both patients and healthcare providers.
Simulation-based education in medicine and healthcare represents a modern pedagogical approach that prepares learners for clinical practice by immersing them in environments that closely replicate real-world physical settings and by employing scenarios that mirror actual clinical situations. This approach is founded on methodology, environments, and technologies tailored to the specifics of medicine and healthcare. Together, they enable the acquisition, development, and enhancement of knowledge and skills, strengthening professional competence, and developing the ability and readiness to act in real work environments without subjecting patients to risks or harm and significantly minimising the possibility of errors in the provision of healthcare services.
These Strategy should be noted that the feasibility and sustainability of implementing this Strategy depend on factors such as political will, allocated resources, and the willingness of experts and enthusiasts to embrace the challenge and take responsibility for turning this Strategy into reality.
When deciding on the integration of a simulation-based educational approach into medical and healthcare education programmes at all levels, it is crucial to establish a comprehensive, structured, and coordinated governance framework for this field. The integration of simulation-based approaches into all levels of medical and healthcare education aims to provide learners—whether in undergraduate studies, residency, or continuing professional development—with the opportunity to acquire new skills or enhance existing ones, clinical decision-making algorithms, and practical actions in clinical situations, all within a safe, controlled, and realistic environment. The primary objective of such a framework is to implement this Strategy while ensuring the sustainable management and long-term development of the simulation-based medical and healthcare sector, in response to the evolving conditions of work and life.

1.1. Quality Education—The Foundation of Quality Healthcare

Quality of care is one of the most frequently quoted principles of health policy, and it is currently high up on the agenda of policy-makers at national, European and international levels (Busse et al., 2019b). Furthermore, this issue will remain relevant in the future, as evidenced by one of the United Nations Sustainable Development Goals—Good Health and Well-Being, which aims to ensure access to high-quality essential healthcare services (The Global Goals, n.d.; United Nations, n.d.).
Delivering quality health services requires competent—that is, well-educated, trained and skilled—healthcare professionals and the cornerstone of building competence for healthcare professionals is education and training (Kreutzberg et al., 2019).
When developing and implementing educational programmes tailored to the specifics of the medical and healthcare fields, it is essential to ensure that their content is evidence-based, up-to-date, and aligned with contemporary practice standards. Moreover, these programmes must adhere to one of the most important principles of medical ethics within the concept of healthcare safety—First, do no harm!
However, according to recent studies, almost one billion people are adversely affected by a lack of access to effectively trained health workers, resulting in illness or death (WHO, n.d.-c).

1.2. Statistical Data Indicates

  • Each year, approximately 3.2 million patients in the EU experience adverse events while receiving medical care. It is estimated that 20% to 30% of these cases are preventable (European Union, n.d.).
  • Each year, 8% to 12% of hospitalised patients suffer complications related to the care they receive in European Union (EU) hospitals (European Union, 2020).
  • Both the World Health Organization (WHO) and the Organisation for Economic Co-operation and Development (OECD) highlight the following in their reports:
    ○
    Globally, unsafe healthcare results in more than 3 million deaths annually.
    ○
    Around 1 in 10 patients are harmed in healthcare.
    ○
    In OECD countries, approximately 15% of inpatient expenditure is consumed by treating the effects of hospital-acquired harm (OECD, 2022; World Health Organization, 2023).
  • In Latvia, over €1 million is paid annually from the Medical Risk Fund for harm caused to patients (LIKUMI.LV, n.d.-c).

1.3. General Aspects Justifying the Need for Integration of Simulation-Based Approach in Medical and Healthcare Education

  • Quality is the optimal balance between implemented opportunities and the system of norms and values. It arises from the interaction between participants who agree on standards (norms and values) and components (opportunities) (Mitchell, 2008).
  • The norms and values of the 21st century in the context of healthcare are reflected in the aspects outlined by the WHO’s concept of “healthcare quality”—safe, effective, people-centred, timely, efficient, equitable and integrated (World Health Organization, 2018).
  • Notably, patient safety has long been seen as an entry point for efforts to improve quality of care, and safe care can be seen as a barometer of the success of basic systems to improve quality (World Health Organization, 2018).
  • Safety is the foundation upon which all other aspects of quality care are built (Mitchell, 2008). All aspects characterising healthcare quality influence or can influence patient safety, which justifies the belief that patient safety is the starting point for efforts to improve care quality.
  • Patient safety is a framework of organised activities that creates cultures, processes, procedures, behaviours, technologies and environments in healthcare that consistently and sustainably lower risks, reduce the occurrence of avoidable harm, make error less likely and reduce impact of harm when it does occur (World Health Organization, 2021).
  • Health systems can only function with health workers (WHO, n.d.-b), and the quality of healthcare services is directly linked to the performance of healthcare professionals, which largely depends on their competence (knowledge, skills, and attitudes). The cornerstone of competence development is education (Busse et al., 2019a).
  • To ensure the production of skilled and confident future doctors, students, and residents must be given ample opportunities to practice and refine their abilities before engaging with real patients (Agrawal et al., 2023). Simulation is increasingly being used in healthcare education to teach cognitive, psychomotor, and affective skills to individuals and teams (Motola et al., 2013).

1.4. Breadth of Simulation-Based Medical Education and Justifying Aspects of Simulation-Based Educational Approaches in Medical and Healthcare Education

With the evolution of the healthcare safety concept, which encompasses both patients’ rights to quality and safe care (WHO, n.d.-d) and healthcare professionals’ rights to a safe working environment (WHO, n.d.-a), the approach to teaching and learning for medical and healthcare professionals has also undergone a transformation. As a result of this transformation, the modern process of medical and healthcare education is now inconceivable without the integration of a simulation-based educational approach.
  • By applying an appropriate methodology in the implementation of simulation-based medical and healthcare education, and integrating simulation-specific technologies and solutions in a suitable environment, it is possible to acquire new skills, enhance previously learned ones, and practise rarely used technical and non-technical skills, ultimately improving patient safety and clinical outcomes (Elendu et al., 2024).
  • The integration of simulations into medical and healthcare education programmes enables preparation for both common daily practice scenarios and rare, complex clinical situations, encountered in daily practice (Elendu et al., 2024).
  • One of the most significant advantages is the opportunity for deliberate practice, where learners can repeatedly perform tasks and refine their skills without risk to patients (Motola et al., 2013). This repetition is crucial for developing proficiency and ensuring that skills are retained over time (Barry Issenberg et al., 2005).
Key benefits of integrating simulation into medical and healthcare education:
  • No risk to patients.
  • Many scenarios can be presented, including uncommon but critical situations in which a rapid response is needed.
  • Participants can see the results of their decisions and actions; errors can be allowed to occur and reach their conclusion (in real life a more capable clinician would have to intervene).
  • Identical scenarios can be presented to different clinicians or teams.
  • The underlying causes of the situation are known.
  • With mannequin-based simulators clinicians can use actual equipment, exposing limitations in the human–machine interface.
  • Full recreations of actual clinical environments allow to explore complete interpersonal interactions with other clinical staff and provide training on teamwork, leadership and communication.
  • Intensive and intrusive recording of the simulation session is feasible, including audio taping and videotaping, there are no issues of patient confidentiality–the recordings can be preserved for research, performance assessment or accreditation.
  • Offers opportunities to work with equipment and tools used in real clinical settings within simulation scenarios, identifying and evaluating limitations in human-technology interaction (World Health Organization & WHO Patient Safety, 2011).
  • Simulation provides a safe environment for learners to make and learn from mistakes, essential for effective learning (Elendu et al., 2024).
  • Fosters clinical reasoning, decision-making, and critical thinking skills while enhancing communication, leadership, and teamwork abilities. It also provides opportunities to test administrative problem-solving skills (Saleem & Khan, 2023).
  • Supports adaptation to evolving demands in the healthcare system (Diaz-Navarro et al., 2024a).
Simulation can also serve as a method for studying aspects such as the interaction between human factors and the work environment (both narrowly and systemically), which influence or may influence the quality and safety of patient care. By using simulations as a research method, existing or new processes can be investigated, the simplicity of checklist usage can be evaluated, and preparation for the use of new equipment or devices can be facilitated (Diaz-Navarro et al., 2024b).
Numerous studies have demonstrated that Simulation improves clinical skills, enhances patient safety, and leads to better clinical outcomes compared to traditional training methods. For example, a meta-analysis of simulation-based education in medical schools found that students trained in Simulation performed significantly better in technical and non-technical skills assessments than those who received traditional training (World Health Organization, 2013).

1.5. Challenges to Implementing Simulation-Based Educational Approaches

Despite its many advantages, SBE faces several challenges. One of the primary barriers is the high cost associated with purchasing and maintaining simulation equipment and the need for specialised facilities and trained personnel. This can be a significant financial burden for educational institutions, particularly those in resource-limited settings. Furthermore, while advanced, the realism of simulations still cannot fully replicate the complexities and unpredictability of real-life clinical situations. This raises concerns about transferring skills acquired through Simulation to actual patient care. Another challenge is the need for faculty training and development. Effective SBE requires instructors to be proficient in the technical aspects of Simulation and skilled in facilitating debriefing and providing constructive feedback. This necessitates ongoing professional development and support for educators, which can be resource-intensive. Despite these challenges, the evidence supporting the effectiveness of SBE is compelling (Elendu et al., 2024).

2. Methods

2.1. Conceptual Framework for the Development Strategy of Simulation-Based Medical and Healthcare Education

2.1.1. Vision

Modern education for current and future medical and healthcare professionals—for quality and safe healthcare.

2.1.2. Mission

Develop a simulation-based education approach and integrate it into medical and healthcare education at the levels of undergraduate studies, residency training, and professional development (hereinafter—“all levels of education”), covering all stages of healthcare (pre-hospital care, primary healthcare, secondary healthcare, tertiary healthcare) to enhance the quality of healthcare and ensure the safety of patients and healthcare professionals.

2.1.3. Values

  • Safety at various levels:
    1.1.
    Safety aspects in healthcare in the broadest sense.
    1.2.
    Safety of healthcare professionals and patients.
    1.3.
    Physical and psychological safety of simulation participants and simulation professionals.
  • Simulation activities as a sustainable resource in the educational process (ensuring compliance with specific requirements regarding content, design, and implementation, as well as effective resource utilisation, considering the ecological impact across all aspects of simulation practices, while supporting the growth and development of the field.
  • Promoting excellence is rooted in the improvement and advancement of all aspects of simulation practice.
  • Mutual respect is a key factor in fostering and maintaining positive collaboration, which is fundamental to the success of any simulation-based education activity.
  • Collaboration is driven by a shared commitment to achieving a common goal: providing the best possible experience for learners while upholding the highest standards of practice.

2.1.4. Overarching Goal

To establish a development and management model for simulation-based medical and healthcare education, strengthening the competence, skills, and readiness of current and future professionals in the medical and healthcare sectors.
A detailed map of the strategic objectives and a comprehensive outline of the strategy’s scope are provided in Figure 1 and Table 1, respectively.
Figure 1. Strategic objective map.
Table 1. Scope of the strategy.

2.2. 1st Strategic Direction: Recognition of Practice in Simulation Learning Environments

By investing in the integration of simulation-based educational approaches into the medical and healthcare education curriculum, the quality of healthcare, as well as the safety of patients and healthcare personnel, are actually enhanced (Slavinska et al., 2024). However, simulation-based education should not be an extra-ordinary activity but must be grounded in the ways learner performance is evaluated and should be built into learners’ normal training schedule. Effective medical learning stems from learner engagement in deliberate practice with clinical problems and devices in simulated settings in addition to patient care experience. Medical education using simulations must be a required component of the standard curriculum (Motola et al., 2013).
The Global Consensus Statement on Simulation-Based Practice in Healthcare encourages policy-makers and managers to formally recognise and harness the benefits of simulation in healthcare practice and education, which ultimately improves patient outcomes (Diaz-Navarro et al., 2024a).

2.2.1. Objective

To structure the medical and healthcare education process into three sequential phases: (1) theory-based learning phase; (2) simulation-based learning phase (practice in a simulation learning environments); (3) work-based learning phase (practice in a work environments). Practice in simulation-based learning environments (phase 2) should be distinguished as a separate part of the medical and healthcare education process—a transitional phase between theory and practice.

2.2.2. Aspects Supporting the Objective

The need to integrate a simulation-based approach in medical and healthcare education is justified by the need to ensure:
  • Healthcare quality and safety.
  • Quality of education in the medical and healthcare fields.

2.3. Healthcare Quality and Safety Within the Scope of Legal Regulations

  • Article 6 of the Treaty on the Functioning of the European Union (TFEU) stipulates that Union shall have competence to carry out actions to support, coordinate or supplement the actions of the Member States, including in the field of protecting and improving human health (European Union, 2012).
  • The EU Regulation (EU) 2021/522 of the European Parliament and Council sets a general objective to improve and promote health across the Union, while one of its specific objectives is to enhance access to quality, patient-centred, outcome-based healthcare and related care services, with the aim of achieving universal health coverage (European Parliament, 2021).
  • The Directive 2011/24/EU of the European Parliament and Council emphasises that, regardless of the opportunities for patients to receive cross-border healthcare, Member States are obligated to ensure safe, high-quality, effective, and quantitatively sufficient healthcare within their own territory (European Parliament, 2011).

2.4. Quality of Education in the Medical and Healthcare Fields Within the Scope of Legal Regulations

  • Education quality refers to the educational process, content, environment, and management that provide inclusive education and opportunities for individuals to achieve excellent outcomes aligned with the objectives set by society and defined by the state (LIKUMI.LV, n.d.-a).
  • The Bologna Process, initiated with the Bologna Declaration in 1999 (signed by Latvia) (European Higher Education Area and Bologna Process, n.d.), is one of the key initiatives at the European level, establishing a unified European Higher Education Area (EHEA) (European Higher Education Area and Bologna Process, n.d.).
  • One of the purposes of the Bologna Declaration (1999) was to encourage European cooperation in quality assurance of higher education with a view to developing comparable criteria and methodologies. The European Ministers of Education adopted in 2005 the “Standards and Guidelines for Quality Assurance in the European Higher Education Area (ESG)” drafted by the European Association for Quality Assurance in Higher Education (ENQA) in co-operation and consultation with its member agencies and the other members of the “E4 Group” (ENQA, EUA, EURASHE and ESU). A new version was adopted in 2015 at Yerevan (Bologna Process, n.d.-b).
  • A key goal of the Standards and Guidelines for Quality Assurance in the European Higher Education Area (ESG) is to contribute to the common understanding of quality assurance for learning and teaching across borders and among all stakeholders. The ESG considers the frameworks for qualifications and the European Credit Transfer and Accumulation System (ECTS), contributing to transparency and mutual trust in higher education within the EHEA (AIC, n.d.):
    ○
    A qualifications framework encompasses all the qualifications in a higher education system—or in an entire education system if the framework is developed for this purpose. It shows what a learner knows, understands and is able to do on the basis of a given qualification—that is, it shows the expected learning outcomes for a given qualification (Bologna Process, n.d.-a).
    ○
    The European Credit Transfer and Accumulation System (ECTS) reflects learning based on specific learning outcomes and the associated workload (European Education Area, n.d.).
  • Learning outcomes are statements regarding what a learner knows, understands and is able to do on completion of a learning process. The definitions and descriptions of learning outcomes as used in qualifications frameworks; qualification standards and curricula are statements and expressions of intentions. They are not outcomes of learning, but desired targets. Achieved learning outcomes can only be identified following the learning process, through assessments and demonstration (European Centre for the Development of Vocational Training, 2022).
The challenge is how to ensure that the intended learning outcomes (the acquisition and assessment of practical skills) are achieved and evaluated without compromising safety and quality standards in healthcare (without exposing either the patient or the professional to safety risks).

Tasks to Achieve the Objective

  • Develop a glossary of terms in the national language that defines the concepts characterising the simulation-based approach in medical and healthcare education.
  • Enshrine in national legal regulations the provision that the simulation-based approach in all levels of medical and healthcare education is classified as a distinct part of the educational process (a phase between theory and practice), incorporating aspects specific to this field (in the context of 2nd and 3rd Strategic Directions).

2.5. 2nd Strategic Direction: Establishing a Management Model for Practice in Simulation-Based Learning Environments

Although simulations are widely integrated into medical and healthcare education, additional challenges reported include insufficient standardisation of simulation training programmes and inadequate quality assurance of practices, particularly related to assessment and faculty development (Cristina et al., 2024). The effectiveness of simulation, like all educational modalities, depends on how well it is used. Simulation should be utilised as an adjunct to patient care experiences, and its integration into the curriculum should be well-planned and outcome driven (Motola et al., 2013).
The implementation process for simulations must align with evidence-based quality assurance approaches and recognised standards of practice, such as the Healthcare Simulation Standards of Best Practice (INACSL) (Charnetski & Jarvill, 2021), The ASPiH Standards—Guiding Simulation-Based Practice in Health and Care (ASPiH) (Lewis et al., 2017), The ASPE Standards of Best Practice (ASPE) (Lewis et al., 2017), and Standards for Organisations that Deliver Simulation-Based Education (NHS) (Standards for Organisations That Deliver Simulation-Based Education, n.d.). Additionally, the process must adhere to an ethics code tailored to the specific requirements of the field (Code of Ethics, n.d.). It is imperative that simulation is used appropriately, employing evidence-based quality assurance approaches that adhere to recognised standards of best practice. These standards include faculty development, evaluation, accrediting, credentialing, and certification (Cristina et al., 2024).
Key organisations driving the development of simulation-based education in medicine and healthcare:
  • Society for Simulation in Healthcare (SSH) (Society for Simulation in Healthcare, n.d.).
  • Society in Europe for Simulation Applied to Medicine (SESAM) (SESAM, n.d.).
  • International Nursing Association for Clinical Simulation and Learning (INACL) (INACL, n.d.-a).
  • Association for Simulated Practice in Healthcare (ASPiH) (ASPiH, n.d.).
  • The Association of Standardized Patient Educators (ASPE) (Association of SP Educators, n.d.).
  • International Network of Simulation Experts “EuSim” (EuSim, n.d.).
  • Swedish Association for Clinical Training and Medical Simulation “KlinSim” (KlinSim, n.d.).

2.5.1. Objective

To develop a management and organisational model for ensuring practice in simulation-based learning environments, based on internationally recognised practice standards.

2.5.2. Aspects Supporting the Objective

  • The European Economic and Social Committee in its opinion highlights that strong and resilient healthcare systems can only be built on an educated, qualified, and motivated healthcare workforce. This workforce is a critical factor in implementing successful health policies and, consequently, improving people’s health (WHO, 2022).
  • The OECD in its report states that the foundations for system resilience and a capacity to minimise harm are found in strong safety governance, a 21st century information infrastructure, and sufficient staffing with a workforce skilled in handling safety risks in complex, dynamic environments, working in a supportive and just safety culture that values continuous learning and improvement (OECD, 2022).
  • World Health Organization (WHO):
    ○
    Educational and training institutions for healthcare professionals should utilise simulation methods with a fidelity level appropriate to the context (high-fidelity methods in resource-rich settings and lower-fidelity methods in resource-limited settings) (World Health Organization, 2013).
    ○
    The Global Patient Safety Action Plan 2021–2030 provides specific recommendations on healthcare workforce education, skill development, and safety, including promoting the use of simulation methods in professional education for medical and healthcare professionals at all levels (World Health Organization, 2021).
  • Adoption of the Healthcare Simulation Standards demonstrates a commitment to quality and implementation of rigorous evidence-based practices in healthcare education to improve patient care (INACL, n.d.-b).

2.5.3. Tasks to Achieve the Objective

1. 
Identify and manage the content implemented in practice in simulation-based learning environments (skills, algorithms, and clinical scenarios), which includes:
1.1.
Define criteria to identify which skills, algorithms, and clinical scenarios should be acquired, developed, and/or assessed in simulation-based learning environments, specifying the educational programme and level.
1.2.
Create a shared database that provides access to the content (skills, algorithms and clinical situations) to be learned in the simulation learning environment.
1.3.
Develop an operational model (processes and technical solutions) for organising the acquisition, development, and assessment of content implemented in simulation-based learning environments (skills, algorithms, and clinical scenarios).
2. 
Establish a quality policy to ensure the acquisition, development, and assessment of content implemented in practice simulation-based learning environments, which includes:
2.1.
Develop a model for the accreditation of organisations implementing simulations or determining the rights to conduct practice in simulation-based learning environments.
2.2.
Develop a certification and recertification model for simulation-implementing personnel (with priority given to simulation instructors).
2.3.
Develop a quality assurance model specifying requirements for the design, implementation, and evaluation of practice in simulation learning environments.
2.4.
Develop and approve a quality policy for recruiting and engaging role players in simulation activities.
2.5.
Develop and approve an ethics code tailored to the specifics of the field, considering recommendations and best practices from leading organisations in simulation-based medical and healthcare education.
3. 
Establish an ecosystem for the structures implementing practice in simulation-based learning environments, which includes:
3.1.
Establish a structure based on principles of interinstitutional collaboration, involving practising professionals with appropriate expertise (hereinafter referred to as domain experts);
3.2.
Develop a system to ensure the acquisition, development, and assessment of content implemented in practice in simulation-based learning environments.
4. 
Establish a funding model to support practice in simulation-based learning environments, which includes:
4.1.
Create a funding calculation model for ensuring the content implementation (skills, algorithms, and clinical scenarios) in simulation-based learning environments, based on previously identified content and considering the resources required for its implementation: technologies, environment, human resources.
4.2.
Develop an interinstitutional shared financial responsibility model for supporting practice in simulation-based learning environments, which includes defining goals and needs, identifying the involved institutions, determining funding sources.

2.6. 3rd Strategic Direction: Integration of Practice in Simulation-Based Learning Environments into All Levels of Medical and Healthcare Education Programmes

The Global Consensus Statement on Simulation-Based Practice in Healthcare emphasises the need to ensure equitable and sustainable access to high-quality, contextually relevant simulation-based learning opportunities, adhering strictly to the principles of equity, diversity, and inclusion (Cristina et al., 2024).

Tasks to Achieve the Objective

1. 
Develop a digital shared platform for key topics in simulation-based medical and healthcare education, including:
1.1.
Educational materials,
1.2.
A database of accredited organisations authorised to implement simulation-based learning environments,
1.3.
A database of certified and recertified simulation instructors,
1.4.
A database of simulation-based medical and healthcare education programmes, etc.
2. 
Educate and inform the creators and implementers of medical and healthcare education programmes about:
2.1.
The simulation-based education approach in medical and healthcare education, its concepts, and associated terminology.
2.2.
Legal regulatory aspects in the context of simulation-based medical and healthcare education.
2.3.
The management and organisational model of practice in simulation-based learning environments.
3. 
Ensure the availability and integration of simulation learning environment infrastructure and technologies in the implementation of simulation-based educational programmes.
Detailed description of the tasks is available in Table 2.
Table 2. Action plan for the implementation of the simulation-based strategy for the development of medical and healthcare education in Latvia 2025–2027.
Progress report on the implementation of the simulation-based action plan for the development strategy for medical and health education in Latvia 2025–2027 as of (1) 1 March 2026; (2) 1 March 2027; (3) 1 March 2028.

2.7. Concept for the Implementation of the Strategy for Simulation-Based Medical and Healthcare Education Development in Latvia for 2025–2027

Implementing simulation-based education remains challenging globally. Strategic leadership and government support are crucial in determining its scope and integration into training programmes (Elendu et al., 2024; Nayahangan et al., 2024). Achieving its full potential requires coordinated action among healthcare and academic stakeholders, along with substantial financial investments, specialised equipment, trained faculty (Cristina et al., 2024), and a robust governance model (Figure 2).
Figure 2. Implementation and coordination group for the strategy for the development of simulation-based medical and health education.

3. Conclusions

The document “Strategy for the Development of Simulation-Based Medical and Healthcare Education in Latvia for 2025–2027” underscores the significance of this field and provides a detailed vision for systematically, sustainably, and thoughtfully developing and integrating a simulation-based educational approach at all levels of medical and healthcare education.
The integration of simulation-based education into all levels of medical and healthcare education is pivotal for strengthening the competencies, capabilities, and readiness of current and future professionals in the field. This, in turn, represents a crucial step toward achieving high-quality education and, consequently, ensuring high-quality and safe healthcare services.
It is essential not to delay the implementation of the Strategy and to initiate the necessary changes to the legal framework. This includes formalising the simulation-based learning phase as a distinct part of the medical and healthcare education process, situated between theory and practice, establishing a management model for practice in simulation-based learning environments, and ensuring the integration of such practices into educational programmes at all levels.
The successful implementation of the Strategy requires:
  • Robust and sustainable collaboration among institutions delivering medical and healthcare education programmes, healthcare institutions, domain experts, and national health policy planners and implementers.
  • The involvement and support of public administration.
  • Long-term resource availability.
  • Regular analysis, evaluation, and timely improvements based on the Strategy’s implementation outcomes.
The implementation of the Strategy and its action plan will be an important contribution to the development of simulation-based medical and healthcare education at national level. It should be recognised that Latvia has the potential to become one of the first countries where this area is managed on the basis of clearly defined conditions and regulated by law. Moreover, if successfully implemented, the Strategy has the potential to become a model or prototype for implementation in other countries.

Author Contributions

Conceptualization, A.S., K.P., E.G. and A.P.; methodology, K.P.; analysis, A.S. and E.G.; investigation, A.S., K.P., E.G. and A.P.; writing—original draft preparation, A.S.; writing—review and editing, A.S., E.G. and E.E.; supervision, A.P. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Institutional Review Board Statement

Not applicable.

Data Availability Statement

No new data were created or analyzed in this study.

Conflicts of Interest

Authors declare no conflicts of interest.

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