“This is a safe space.”
It’s the standard opening for almost every clinical simulation session.
It’s also not entirely true. It’s not a malicious lie, but it is a fiction that everyone in the room quietly accepts.
In simulation-based education, ‘psychological safety’ isn’t just unattainable, it’s the wrong goal altogether.
Why the Promise of Safety Falls Short
The promise of safety is nearly impossible to keep for three key reasons.
Someone is always watching. Whether formally or informally, performance gets noted. Reputations are quietly shaped based on what happens.
Power dynamics don’t disappear. The consultant still outranks the registrar. Hierarchies don’t dissolve just because we dim the lights and start a scenario.
The stakes are real. A fumbled procedure or missed diagnosis doesn’t stay confined to the simulation suite. It can influence how colleagues view someone’s clinical competence going forward.
The Fundamental Contradiction
This creates a contradiction. Effective simulation is meant to be stressful. We deliberately create cognitive pressure to mirror real clinical crises because, as research shows us, some degree of stress is necessary for peak performance and learning.
We’re asking learners to feel safe whilst we intentionally make them uncomfortable. It’s a fundamentally dishonest position.
A Better Approach: Brave and Redeemable Spaces
The solution isn’t to try harder to create safety, it’s to abandon the pretence entirely. We need to offer a more honest contract, shifting our goal from creating a ‘safe space’ to building a ‘brave and redeemable’ one.
This requires a framework of bounded risk. It means being transparent about the managed discomfort we’re creating and the guardrails we’ve put in place. It means guaranteeing that whilst decisions will be challenged, a person’s dignity and worth never will be.
Most importantly, it means offering redemption. When a critical moment goes badly, learners must have the chance to try again. This ensures their final memory is one of competence, not failure.
Building Real Trust
Trust isn’t built on hollow promises. It’s built by being honest about risk and clear about our commitments to learners.
Let’s stop chasing the illusion of safety and start building spaces where people can learn within clear, respectful, and honest boundaries.
That’s how we truly prepare clinicians for the realities they’ll face.