The Global Network for Simulation in Healthcare (GNSH) was formed to address a perceived international void in the collaborative pursuit of open communication, mutual interests and opportunities. Judith Riess provides an update.

Five leaders, representing different organizations (SSH, SESAM, ASSH, INACSL, and the London Deanery), came together to develop an understanding of the needs of the global simulation community. The group recognized that no single organization could represent international issues, and hoped to use this opportunity to leverage the collective knowledge and strengths to examine simulation through a global lens.

The inaugural meeting was held in 2010 in London, UK, and was attended by fifteen organizations with a strong interest in healthcare simulation. In 2011, seventeen organizations signed the “London Concordat”, thus crystallizing the group around its mission and goals.

The primary goal was to build strong relationships across the diverse international simulation community. Recognizing that, in addition to the not for profit groups, the commercial side of the industry needed a voice, GNSH invited eight international commercial industry partners to participate as guests at the 2014 summit in Edinburgh. At the conclusion, the GNSH members voted to include the commercial members upon signing the Concordat. The GNSH Executive Committee was expanded from six members to nine, with not for profit organizations and commercial representation.

The Edinburgh meeting provided an opportunity for participants to identify and align around common goals, and strategize on barriers. The idea emerged that the community would benefit from reframing how we approach simulation. At its core, healthcare has specific priorities and challenges. Decision-makers often base their strategies and choices around these issues. GNSH has now focused its attention on helping the community evolve from advocating for simulation to improve clinical skills, to advocating for simulation to provide solutions.

Providing guidance on how to demonstrate value to key decision-makers, such as financial officers, educational directors, healthcare and college executives, and policy makers, would be beneficial. The GNSH Executive Committee, chaired by Michael Seropian, MD, started a multi-year initiative to focus the use of simulation around value (healthcare outcome divided by resources used). The intent was to provide the global community with tools and strategies to prepare them to better understand and to influence their respective decision-makers.

GNSH 2015 was held in Stavanger Norway; the Utstein Style consensus process was adapted to develop consensus guidelines for value-based simulation. This was particularly interesting because Utstein had previously played a historic part of the formation of International Liaison Committee on Resuscitation (ILCOR).

The GNSH 2015 participants (Figure 1) worked intensively to understand specific areas of value for five key decision-making groups: executive leadership, policy makers/regulatory bodies, professional associations, payer/insurers and educators/educational leaders. A modified Delphi technique was used to suggest possible priorities for the leadership of each group. After debate and discussions within each group, members of other groups critiqued these assumptions. This approach allowed GNSH participants to identify areas of overlap across decision-making groups, as well as areas that were group specific. The results underscored and validated the idea that different decision-makers have specific value sets. This is further amplified by significant variations geographically, for example, the same issue in the Netherlands would probably result in an entirely different outcome in the United States.

A small group of members convened in December 2015 for a 3 ½ day meeting to analyze and synthesize the data gathered in Stavanger. The information was put into a common framework, designed to be understandable, scalable, globally relevant, and accessible. The final product will include exemplar case studies relating to real events and real problem-based solutions. The case studies will be available for all to use. The outcome of the work will be available to the simulation community within 6-12 months, as will a descriptive paper on the evolution of GNSH into a Community of Practice.

GNSH will become a formal association in January 2016 achieving a significant milestone. The inaugural Board of Directors will be the current nine members of the GNSH Executive Committee (Table 1). The organization looks to expand its membership to have a broader representation of the simulation-relevant industries. GNSH leadership will share progress and seek global input through presentations at major international conferences. GNSH 2016 will be held in Oxford, UK.

GNSH Executive Committee (December 2015)

Michael Seropian (USA) - Chair

Carol Durham (USA)

Linda Crelinsten (Canada)

Patrick Van Gele (Switzerland)

Clive Patrickson (Norway)

Stephanie Sudikoff (USA) - Vice Chair

Kevin Stirling (Scotland) - Treasurer

Ralf Krage (Netherlands)

Lucas Huang (USA)

Andy Anderson (UK) – Executive Director


GNSH London Concordat Signatories


  1. Associação Brasileira de Simulação na Saúde, Brazilian Association for Simulation in Healthcare (ABRASSIM)
  2. Association for Simulated Practice in Healthcare (ASPiH)
  3. Association for Standardized Patient Educators (ASPE)
  4. Australian Society for Simulation in Healthcare (ASSH)
  5. Canadian Network for Simulation in Healthcare (CNSH)
  6. Dutch Society for Simulation in Healthcare (DSSH)
  7. French Society for Simulation in Healthcare (AFSARMU)
  8. International Nursing Association for Clinical Simulation and Learning (INACSL)
  9. International Pediatric Simulation Society (IPSS)
  10. Japanese Society for Instructional Systems in Healthcare (JSISH)
  11. Korean Society for Simulation in Healthcare (KoSSH)
  12. Latin American Association of Clinical Simulation (ALASIC)
  13. The London Deanery
  14. Polish Society for Medical Simulation (PSMS)
  15. The Royal College of Physicians and Surgeons of Canada (RCPSC)
  16. Spanish Society for Simulation in Healthcare (SESSEP)
  17. Swiss Association in Simulation in Healthcare (SASH)
  18. Society for Simulation in Healthcare (SSH)
  19. Society in Europe for Simulation Applied to Medicine (SESAM)


  1. B-Line Medical
  2. CAE Healthcare
  3. Innovation in Learning Inc. (Clinispace)
  4. Education Management Systems
  5. Laerdal Medical
  6. Limbs & Things LTD
  7. Simbionix (pending) – Now 3D systems
  8. Simulab Corporation
  9. Surgical Science