The Østergaard Declaration

Simulation-based education and training (SBET) has moved beyond innovation or educational novelty; the evidence for its effectiveness in improving clinical competence, team performance, organisational learning, and patient safety is now well established. The central challenge is no longer whether simulation works, but why it remains inconsistently implemented, unevenly funded, and insufficiently embedded within healthcare and training systems. SBET must be recognised as core healthcare and educational infrastructure—planned, governed, resourced, and integrated across the full professional life cycle, with appropriate support for simulation faculty and systems-level implementation. Achieving this will require coordinated action from professional societies, regulators, educators, and healthcare institutions to move from evidence to sustained implementation. Simulation is now a professional, organisational, and ethical imperative.