PT - JOURNAL ARTICLE AU - S Arora AU - Nick Sevdalis TI - Hospex and Concepts of Simulation AID - 10.1136/jramc-154-03-19 DP - 2008 Sep 01 TA - Journal of the Royal Army Medical Corps PG - 202--205 VI - 154 IP - 3 4099 - http://militaryhealth.bmj.com/content/154/3/202.short 4100 - http://militaryhealth.bmj.com/content/154/3/202.full SO - J R Army Med Corps2008 Sep 01; 154 AB - A conceptual three-level framework is presented for understanding the aims, scope and potential outcomes of simulation in healthcare contexts. At the first level, micro-simulation aims at honing basic technical skills of individual clinicians. At the second level, meso-simulation aims to train clinicians to work more effectively and efficiently as part of a clinical team. At the third level, macro-simulation aims to assess organisational fitness for purpose at large scale. We discuss HOSPEX as an exemplar macro-simulation and argue for needs- and evidence-based implementation of simulation-based training at micro, meso and macro levels.