{
  "abstract": "Objectives The immersive simulation aimed to reveal how users experience the early stages of a care pathway from referral to multidisciplinary team (MDT) review. It sought to expose hidden barriers, assumptions, communication challenges, and accessibility issues that are not visible in formal process maps or routine performance data. It aimed to strengthen shared understanding across staff roles.Methods A full day immersive simulation was delivered in a neutral Hydra style environment using authentic materials and decision points. Mixed groups of allied health professionals, administrative staff, trainees and external partners worked through a realistic reconstruction of the user journey, followed by plenary debriefs. Data was gathered through facilitator observations and written logs, and analysed thematically to identify accessibility barriers, communication issues, decision point variation, and role related uncertainty.Results Nine cross cutting insights emerged. Participants discovered that the real user journey is more complex than the documented pathway; communication quality significantly shapes engagement; and accessibility barriers accumulate early, particularly for digitally excluded or seldom heard groups. The simulation exposed role ambiguity, inconsistent decision-making practices, assumptions regarding referral quality, and the importance of psychological safety in enabling honest reflection. These findings highlighted several targeted improvements that could benefit users.Conclusions The exercise demonstrated that immersive simulation is a powerful service improvement method that reveals hidden system dynamics, strengthens multidisciplinary understanding, and supports person centred redesign. Early outcomes included improved communication materials, clearer referral guidance, enhanced role clarity, and earlier digital support. The approach offers practical, transferable value for rural, multidisciplinary services seeking to improve accessibility, equity and user experience.",
  "authors": [
    {
      "affiliations": [
        "Business Manager, Powys Living Well Service, Powys Teaching Health Board, UK"
      ],
      "name": "Tim Smith"
    }
  ],
  "title": "1 Using Immersive Simulation to Improve Service Design and Access to Health Services in Rural Wales",
  "uid": "d998362c-4e92-53be-8f5f-32ba0e3d7a57"
}