Part of the problems for me in this course is that it is based in the US. The education systems are different enough to make it harder to map this across to my experience.
A study by Jennifer Hayden et al., completed a randomised trial to discover the amount of real clinical time vs simulation. They found that up to 50% of the simulation can be substituted for traditional clinical experience. 50% of the sim can effectively be used in different geographical areas, and still have good educational outcomes. The substitution has no impact on pass rates. They noted that faculty should be traned using simulation pedagogy, and use a theory based debriefing method. It is in the reflection that theory and practice are connected. Supplies and resources were key. Use of faculty preparation checklists support universities to check if they are ready.