Sains Malaysiana 49(8)(2020): 1987-1993 http://dx.doi.org/10.17576/jsm-2020-4908-21 Simulation in Healthcare in the Realm of Education 4.0 (Simulasi dalam Penjagaan Kesihatan di Alam Pendidikan 4.0) ZALEHA ABDULLAH MAHDY, MUHAMMAD MAAYA, IXORA KAMISAN ATAN, AZLAN HELMY ABD SAMAT, MOHD HISHAM ISA & ISMAIL MOHD SAIBOON* ABSTRACT The advent of Education 4.0, in parallel with Industrial Revolution (IR) 4.0, has translated into an evolution in healthcare education. Simultaneously, as a result of concerns in doctors’ competency and patient safety, simulation shot into center-stage in the feld of healthcare education. Generally, there are fve modalities in healthcare education, namely role-play (verbal), standardized patient, part-task trainer, computer or screen-based simulation, and electronic patients including virtual reality. Dissecting the nine principles of Education 4.0, this article reviews the relevance and role of the fve diferent modalities of simulation in easing healthcare education into the mold of Education 4.0. Keywords: Education 4.0; healthcare; industrial revolution; mobile learning; simulation ABSTRAK Kemunculan Pendidikan 4.0, selari dengan Revolusi Industri (IR) 4.0 telah melahirkan sebuah evolusi dalam pendidikan penjagaan kesihatan. Seiring dengan perkembangan tersebut serta kebimbangan mengenai kecekapan para doktor dan keselamatan para pesakit, simulasi menyerlah sebagai salah satu kaedah yang penting dalam bidang pendidikan penjagaan kesihatan. Pada umumnya terdapat lima modaliti simulasi kesihatan iaitu lakonan (bertutur), pesakit piawai, simulator-tugasan-separa, simulasi komputer atau berasaskan skrin dan pesakit elektronik termasuk realiti maya. Dengan merujuk kepada prinsip Pendidikan 4.0, kertas ini mengulas kerelevanan dan peranan yang dimainkan oleh kelima-lima modaliti tersebut dalam pendidikan penjagaan kesihatan berasaskan simulasi dalam kerangka wadah Pendidikan 4.0. Kata kunci: Pembelajaran bergerak; pendidikan 4.0; penjagaan kesihatan; revolusi industri 4.0; simulasi INTRODUCTION Over the last few centuries, the world has been greatly shaped by four industrial revolutions (IR): The steam engine (IR 1.0); The production line (IR 2.0); The computer (IR 3.0); and The internet (IR 4.0) (Intelitek 2018), with the latest revolution merging the physical and virtual domains. Healthcare education is no exception in having to keep up with the latest ideas and practice of education in general, which must be kept abreast with the industrial revolutions. It is unreasonable to stick to older methods of teaching and learning when the needs of the healthcare profession has changed in line with IR 4.0. To reach out towards an improved outcome, a paradigm shift is in order. New objectives and aspirations require a new mindset and skillset, accompanied by new tools and armamentarium. Medical education must gear itself towards competency based education with the aim of achieving mastery skills rather than remaining merely knowledge based. Simulation is a technique to replace or amplify real patient experiences with guided experiences that are artifcially contrived and evokes or replicates substantial aspects of the real world in a fully immersive and interactive manner (Gaba 2004). It is mainly used as a teaching and learning method, apart from assessment and research (Ismail et al. 2019), having been practiced in various other felds outside healthcare such as aviation, judicial, and military education (Riley 2015). In healthcare education, simulation is in fact not new either, and has been in practice since ancient Chinese civilization. More recently, simulation has revolutionized healthcare education, with much renewed interest and scaling greater heights in terms of usage, variety, and creativity. Apart from formal teaching and learning, simulation plays an important role in preparing healthcare workers in anticipation of managing crisis and disease outbreaks, like the recent COVID-19 pandemic (Wong et al. 2020). The rapid progress in electronics, communication technology and artifcial intelligence has enhanced the world of simulation in healthcare education to a huge extent.