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How is it possible to prepare health care workers even for the most unexpected situations? Why is muscle memory essential for safe patient care, and how can newly graduated doctors have it? Education based on simulation plays a key role in answering these questions. Dr. Szilárd Rendeki and Dr. Péter Maróti, Heads of the Medical Skills Education and Innovation Centre at the University of Pécs Medical School, gave us an insight into this.

Written by Miklós Stemler

Those who can, do; those who cannot, teach is a common saying, but, like many others, it should be treated with suspicion. It still highlights the complex relationship between practical and theoretical knowledge, education and teaching, which remains one of the key challenges in medical education today. How can doctors safely learn procedures to be performed on patients without practicing on real patients? And can newly graduated doctors develop the skills they need to handle real-life situations, such as emergency care, from their very first day? The Medical Skills Education and Innovation Centre of the University of Pécs Medical School works to answer these questions. By combining the latest simulation technologies and teaching methods with proven approaches, students have the opportunity to develop those essential basic skills which would make the difference between life and death in real-life situations.

The dilemma is simple, for physicians and healthcare professionals adequate practice and routine are essential. Learning skills would require real patients, even though young healthcare professionals often lack the experience needed to provide safe patient care. Simulation-based education offers a solution to this basic contradiction, which has long been an important part of education, it has also undergone major methodological and technological development in the last couple of decades. A basic example of training based on simulation is practicing first aid with an equipment, but medical education uses much more advanced methods.

More than hardware and software

– We tend to think that simulation-based training consists of simulators and highly developed virtual reality systems, but it is important to know that real work does not start with them, since they are only hardware and software – mentions Dr. Péter Maróti, who studies Medical Sciences in Medical Education at Harvard, a leading institution in simulation-based education.

Even the most sophisticated tools are of little use without the right foundations such as the basic principles and the right learning environment. When designing a simulation, the first step is to define the goal: what skill, behaviour, decision-making process or professional competence should the student develop. This goal must be measurable so that objective feedback can be given at the end of the training session. Before the simulation, there is also a briefing, where the task and expectations are clearly explained.

Having the basic rules set, the next step is to suspend disbelief, whether the exercise is a basic procedure or a complex operation in a highly realistic setting.

– A simulation can never fully recreate a real clinical environment, but we need to define clear conditions and a scenario that everyone follows throughout the exercise to maintain its realistic aspect. Although we know that the situation is not exactly the same as reality, everyone should behave as if they were in a real clinical situation. The exercise ends with another discussion, where the participants and the leader of the simulation can openly share and discuss their experiences. A simulation can take many forms, from a simple resuscitation to a complex procedure under general anaesthesia, but following this framework is essential for its success – emphasizes Dr. Péter Maróti.

Essential preparation for newly graduated doctors

Advanced simulation-based education at the University of Pécs Medical School covers the entire patient care, marking an important shift in focus. When the MediSkillsLab was founded in Pécs in 2012, its main goal, similar to centres around the world, was to develop practical medical skills, as its name suggests. Over the years its mission has expanded. Today, it is not only about practicing procedures and routines, but also about a teaching approach that goes through the entire medical education. The heads of the Centre hope that this approach may also contribute to the reform of medical education in the future.

– In my opinion it would be an important goal that newly graduated doctors have the knowledge and skills to work safely in emergency care without any additional training needed. To achieve this, we need to clearly define the learning outcomes: knowledge and skills that our students should have when they graduate, the basic toolkit that they need to succeed – says Dr. Szilárd Rendeki.

There are many basic medical skills, such as urinary catheterisation, putting on sterile gloves and using medical equipment, that I believe should not be taught separately within individual subjects, but as part of a comprehensive medical skills programme. This would definitely require a lot of work, but the extra effort invested in undergraduate education would pay off many times over. If newly graduated doctors already have these basic skills, they would not have to learn them during the residency programme or while working in emergency care. The biggest winners would be the patients receiving safer and high-quality care overall.

Be ready for the unexpected

An important role of simulation-based education is not only to help future doctors and healthcare professionals practise the most common procedures, but also to prepare them for unexpected situations that can interrupt their daily routine. For example, body hair can make it difficult to place electrodes during an examination, and this may seem trivial or even funny, but it can cause serious problems in a real-life situation, such as when it delays the examination of a patient suspected of having a heart attack. Although there is no special body-hair simulator, advanced simulation-based training prepares students for many small but important details.

– You can tell who has already worked with real patients and who has only learned about healthcare from films or TV series by small things such as how they shake an ampoule or remove air from a syringe – adds Dr. Szilárd Rendeki. – This is the kind of practical knowledge that cannot be learned from books but is very important in everyday work.

The goal is to develop a kind of muscle memory that allows newly graduated doctors and healthcare professionals to perform confidently in a high-pressure clinical environment from their very first day.

– In a clinical setting, you must focus on many things at the same time. This becomes much harder if you also have to think about how to change sterile gloves or how to use basic medical equipment. This is not simply about practice. The goal is to develop the ability to perform these simple actions almost instinctively, as they form the foundation of every examination and procedure carried out in real-life situations – explains Dr. Szilárd Rendeki.

In search of black belt clinicians

This special form of education also requires special lecturers.

– A good leader of a simulation is a black-belt clinician with extensive clinical experience who also has strong teaching skills and is willing to keep learning. This is important because simulation-based education is not simply about having instincts, it has its own rules and professional approach – highlights Dr. Szilárd Rendeki. He also mentions another important point that experience shows that younger instructors often have an advantage, precisely because their knowledge is not too far ahead of that of their students.  

– A doctor who has been working for several decades might not be able to perfectly recall what it was like to be a beginner and may find it difficult to return to that level to be effective. A young specialist or even a resident better understands the challenges a beginner faces and can more realistically explain what they really need to learn to avoid problems in patient care. Many of our instructors are former students who enjoyed working here so much that they returned as lecturers after graduation.

– Medical students are not children, they are adult learners who should be treated as partners – adds Dr. Péter Maróti. We need to create an environment where students understand why knowledge is important to them, so this motivates them to learn it.

The effectiveness of this approach is demonstrated by the success of the medical students from Pécs at one of the world’s oldest and most prestigious medical competitions. A Hungarian team took part in the competition in the Czech Republic for the first time, and the students finished 3^rd among 14 teams.

– This success is a good example of what a motivated and confident team can achieve. The students organised their own training, chose their lecturers and, through a lot of practice, they developed skills that proved effective in a real-life situation – says Dr. Szilárd Rendeki.

Kitchen sponge vs. virtual operating room

The success of the students from would not have been possible without the support provided by the Medical Skills Education and Innovation Centre. This is also quite unique, as simulation-based education generally does not play as central a role in medical training as it does at the University of Pécs Medical School.

– The United States of America is the world leader in healthcare simulation education, but it has mainly been developed for nurses there, who also perform certain medical tasks. The innovation in Pécs is that we give simulation-based education a central role in medical education, as well. The results have confirmed the effectiveness of this approach – emphasizes Dr. Szilárd Rendeki.

– It required continuous learning from our side as well – adds Dr. Péter Maróti. – When we started, simulation-based education was still in its early stages in Hungary, and we realised how important a strong methodological foundation is. It is easy to be impressed by an incredibly realistic virtual reality system, but without the right educational framework, its benefits are limited. The literature also shows that VR solutions were surrounded by excitement a few years ago, while enthusiasm has become much more moderate today. We need to carefully consider what works in each situation and what we want to achieve with a particular exercise. It may even happen that a simple kitchen sponge helps to give better results than a sophisticated virtual reality environment.

Of course, this does not mean that students only get to use kitchen sponges during their training. Thanks to continuous development, the Centre, 1,600 m², has equipment meeting international standards, various VR and AR solutions, a fully equipped training operating room, a special operational medicine room, and a custom-developed smart IT and audiovisual system. These provide highly realistic simulations covering the full range of healthcare.

A bridge to safe patient care

Although students can learn a lot through advanced education based on simulation, the heads of the Medical Skills Education and Innovation Centre agree that it can never fully replace learning with real patients.

– The relationship between doctors and patients, communication with relatives, physical examination, and the presence and reactions of a real patient provide an experience that no simulator can fully replace. At the same time, there are many procedures that, in today’s legal, ethical and patient safety environment, should only be performed on real patients after appropriate training. The two approaches are not alternatives to each other, but they complement each other when it comes to medical education – says Dr. Szilárd Rendeki.

– Good simulation-based education can achieve a lot as it creates a safe environment, allows situations to be repeated, provides controlled feedback, and gives students the opportunity to make mistakes without consequences. However, it cannot fully reproduce the psychological pressure of working with a real patient. An equipment or an actor can be very realistic but knowing that you are dealing with a real person creates a different kind of cognitive and emotional pressure – explains Dr. Péter Maróti. From his point of view, simulation-based education can serve as a safe bridge between the world of the university and the reality of clinical practice. Students can move back and forth across this bridge, practise, take a break, and strengthen their knowledge and skills at their own pace.

More than a place for doctors

Although the Centre’s main role is to educate medical students and students in other healthcare programmes, it also aims to improve health awareness among the community. The Police Medic programme has been running for more than a decade, teaching police officers practical life-saving skills that have already helped save lives. Last year, 160 infant and early childhood educators from Pécs and the surrounding area took part in a course that taught them how to deal with common accidents involving young children and how to recognise the symptoms of serious illnesses. Since 2022, the Rural Lifesaving Programme has also been supporting small communities where access to trained healthcare professionals is limited. Dr. Szilárd Rendeki hopes that the Centre will have the opportunity to offer even more such programmes in the future.

– Improving basic health knowledge in society is especially important nowadays. On the one hand, the internet and various programmes based on artificial intelligence provide access to a huge amount of information, but the reliability of this information is often questionable. This is not our main task, but we see ourselves not only as a centre for higher education, but also as a place where knowledge can be shared with the wider community. Personally, I would be happy to open the Centre to students from other faculties as well, because a teacher, lawyer or economist may find themselves in a situation where basic healthcare and first-aid knowledge can be crucial.

The world's leading simulation organization accredited the MediSkillsLab at the University of Pécs Medical School

In mid-summer 2026, the news came that the Medical Skills Education and Innovation Centre at the University of Pécs Medical School is the first institution in Hungary to receive the Provisional Accreditation from the Society for Simulation in Healthcare (SSH), the world's largest healthcare simulation accreditation organization. The accreditation was earned on 21 July and is valid until the end of 2028.

As we previously reported, the Society for Simulation in Healthcare has more than 5300 members from nearly 70 countries. The organisation supports the improvement of healthcare education and patient care by promoting trainings based on simulation and innovation. Since the launch of its accreditation programme, the SSH has accredited more than 290 institutions and programmes worldwide playing a leading role in ensuring the quality of healthcare simulation education at the international level.

The accreditation of the Medical Skills Education and Innovation Centre is the result of several years of development and preparation. During the accreditation process, experts evaluated many aspects of simulation at the centre, including education, organizational structure, and quality assurance.

After evaluating the submitting documentation, an online expert interview and request for additional information followed. Reviewers evaluated the centre's activities in seven areas of education based on simulation and confirmed that it met 59 accreditation criteria. The accreditation is valid from 21 July 2026 to 31 December 2028.

„This accreditation does not only mean international recognition of the work at the centre, but it is also an important milestone in the University of Pécs Medical School’s commitment to education based on simulation. This achievement reflects the dedicated teamwork of our lecturers, colleagues, and technical personnel, as well as the strong support of the leadership of the faculty” – said Dr. Szilárd Rendeki.

He added that by receiving the accreditation, the Medical Skills Education and Innovation Centre of the University of Pécs Medical School had become part of a professional community on an international level which aims to develop the highest standards of education related to healthcare simulation. It also creates new opportunities for international collaboration, knowledge sharing, and further development of education.

The evaluators of the SSH highlighted the centre’s well-prepared and dedicated leadership, the consistent use of data-driven best practices, and its broad range of educational research related to simulation-based medical education.

„This feedback shows that modern simulation infrastructure is no longer enough to be among the world's leading institutions. Education must be based on scientific evidence, and its outcomes must be continuously measured and improved. This is exactly what we are working on in Pécs, and we aim to help shape the future of simulation-based medical education through our research” – emphasized Dr. Péter Maróti.

Photos:

Kerekes Fotó & Film

Szabolcs Csortos (University of Pécs)