Table 2.

Ethical considerations in simulation in healthcare provided during the consultation process

Theme	Considerations
Equity of access	High quality healthcare including dental, mental health and social care, should be universally accessible - Workforce burnout globally - Support for staff in difficulty Equitable access to education - Identification of educational requirements: “Learners don’t know what they don’t know” - Prioritization of time and staff investment into educational activities - Cost of training and availability of resources - Identification of pathways for resource sharing (e.g. faculty exchanges or “pack-and-go” approaches) - Affordability of faculty development in low resource settings - Equitable fees for access to international resources
Safety culture	Safety to learners and patients (psychological and physical) - Balancing safety of learners and patients when red flags are demonstrated Protection of confidential patient information Psychological safety in debriefing - Supported by faculty training - Confidentiality - Support learner vulnerabilities Avoidance of “shame and blame” culture, both in simulation and healthcare settings
Acknowledgement of diversity equity and inclusion (DEI / EDI)	Cultural differences Silo practices Multicultural societies Complex cultural variation within one area Ethnic minorities Equitable partnership between - health profession - first responders and care providers - national and international collaborations
Emerging technologies	Use of new technologies and benefits v risks: - Digital twins - Computer modeling and data generation to support research and analysis - AI as an enabler, a tool to deal with complex tasks
Sustainability	Carbon footprint of simulation Workforce sustainability in education and healthcare Sustainability of simulation programs