Digital simulation in postgraduate maternal medicine education: an evaluation of educational, environmental, and financial outcomes

Abstract Background Simulation-based education (SBE) is widely used in postgraduate healthcare education but is resource-intensive, requiring participant travel, multidisciplinary staffing, specialist facilities and consumable resources. Digital simulation offers opportunities to improve accessibility and scalability while potentially reducing environmental and financial impacts. However, evidence evaluating these sustainability outcomes remains limited. Objective To evaluate the educational, environmental and financial outcomes of digital simulation within a postgraduate maternal medicine module. Methods A multi-method educational evaluation was undertaken using participant questionnaires, narrative comments, travel information and comparative environmental and financial modelling. Educational outcomes were analysed descriptively using Likert-scale responses and content analysis of narrative comments. Environmental evaluation compared the operational carbon emissions associated with equivalent face-to-face and digital simulation delivery using predefined system boundaries, while financial evaluation compared the recurrent costs of face-to-face delivery with the one-off production costs of digital simulation. The study was conducted within a national postgraduate maternal medicine module delivered by the University of Greater Manchester in partnership with the Northwest Maternal Medicine Network. All fifteen enrolled healthcare professionals participated. Results Participants reported consistently positive educational experiences, with all respondents agreeing or strongly agreeing that the digital simulations supported clinical decision making, realism, interprofessional learning and application to practice. Nine participants (60%) reported that they would not have been able to attend an equivalent face-to-face simulation. For the remaining six participants, estimated participant travel related emissions associated with equivalent face-to-face attendance total 135.45 kg CO 2 e. Production of the digital simulation required one return rail journey, generating an estimated 25.67 kg CO 2 e. The estimated recurrent cost of delivering an equivalent face-to-face simulation was £2,702,04 per session, whereas the digital simulation required an estimated one-off commercial production cost of approximately £4,500 with no ongoing hosting costs reported by the platform provider. Conclusion Digital simulation was perceived as educationally valuable while substantially improving access for a geographically dispersed postgraduate cohort. Compared with repeated face-to-face delivery, digital simulation reduced participant related-travel emissions and eliminated recurrent delivery costs, although production required an initial environmental and financial investment. These findings demonstrate the importance of evaluating educational innovation beyond learner outcomes by incorporating environmental and financial considerations alongside educational effectiveness.