Ready. Set. Simulate! Duke-NUS team wins medical SIMWars | MEDICUS 2025 Issue 1

Ready. Set. Simulate! Duke-NUS wins medical SIMWars
By Helmy Sa'at, Media & Content Specialist

Congratulations to (L–R) Wharton Chan, Aadya Deshpande, Brian Fu, Pierre Yim and Jedidiah Ng, pictured here with one of the judges, Prof Fatimah Binte Abdul Lateef, for winning the Medical School SIMWars held at the Centre for Healthcare Innovation // Credit: Dr Hoe Pei Shan

In a high-stakes medical emergency, seconds separate life and death. But how do you train for situations that are unpredictable, chaotic, and ever-changing?

“They are very passionate, and I do admire their camaraderie. They really worked together as one. And they were all determined to win.”
Ms Abegail Resus Fernandez

Enter SIMWars—a high-intensity medical simulation competition where student teams race against the clock to diagnose and treat simulated patients under the watchful eyes of expert judges.

For the Duke-NUS team—comprising Pierre Yim, Wharton Chan, Aadya Deshpande, Brian Fu and Jedidiah Ng—months of rigorous training paid off when they clinched the championship title at the Medical School SIMWars competition at the Centre for Healthcare Innovation on 21 December 2024.

A triumph well-earned. But how exactly did this team earn their crowns?

Assembling a gold team

SIMWars, an educational competition organised by the Society for Emergency Medicine (Singapore) in the run up to its annual meeting, is not for the faint of heart (pun intended!), with students challenged by all kinds of emergency medicine scenarios, ranging from dangerously low blood pressure to cardiac arrests. Anything and everything could happen. Teams step into the simulation lab not knowing what ails the simulation manikin awaiting them.

They are expected to tap their medical knowledge and translate it into clinical diagnoses and treatment decisions, executed with effective communication and teamwork. Oh, and to keep the patient alive and well from whatever medical malaises they were suffering.

The open call to participate in SIMWars was sent out to all fourth year MD students in September 2024, with the selection process carried out in the last week of that month. From a pool of about 70 students, 10 expressed their interest.

“We didn’t want all followers or all leaders, but we wanted a mix. So, everybody had a chance to use their best skills to make the team stronger than if they were all team leaders or individuals, who are just followers with good medical knowledge, but couldn’t speak or communicate well. It was a deliberate attempt to have a team that had many strengths,” said Evelyn Wong, a clinical associate professor from the SingHealth Duke-NUS Emergency Medicine Academic Clinical Programme, who was largely responsible for putting together and overseeing the team’s training.

The team on the day of the competition, being monitored by the judges of SIMWars

Duke-NUS team on the day of the competition, being monitored by the judges of SIMWars // Credit: Dr Hoe Pei Shan

The Duke-NUS team pictured here with Abegail Resus Fernandez // Credit: Courtesy of Abegail Resus Fernandez

And, then there were the chosen five.

“I guess it was a mix of fear and not wanting to let down the faculty and staff who trained us. We just wanted to tie everything together before the big day.”
Mr Brian Fu

The preparation was intense. Gruelling, even.

Over the three months leading up to the competition, the team completed a total of 12 training sessions as well as instruction and testing in Advanced Cardiovascular Life Support and Advanced Trauma Life Support skills. Needing to fit their training around their clinical rotations meant that each three to four-hour-long session could only start after 5pm, stretching well into the night.

And, during each training session, they worked through two to three medical scenarios, applying their medical knowledge and honing their clinical skills.

Even after all that intensive training, the team asked for an additional session, squeezed in just two days before the competition, which made it a total of 13!

The Duke-NUS team during an immersive simulation training session in preparation for the SIMWars // Credit: Abegail Resus Fernandez

“I guess there’s a mix of fear and not wanting to betray the expectations of all the faculty and staff who have spent their time and energy preparing us. For us, we were just trying to do anything at the last minute to kind of really tie everything together,” emphasised the team lead, Fu, 26.

A similar sentiment was echoed by Chan who aptly summed it up: “The biggest hurdle was just not totally knowing what we were about to face on the day of the competition.”

"We didn’t want all leaders or all followers. We needed a mix—individuals who could balance leadership, teamwork, and communication. That’s what makes a team stronger.”
Clin Assoc Prof Evelyn Wong

“At the same time, we didn’t know to what degree our competitors had been practising and there’s no so-called syllabus for this competition,” shared Chan, who like Deshpande, is an MD-PhD student.

“It was quite surreal to see the other teams in the room, and there was this competitive spirit,” added the 31-year-old, who believed that “the competition drove stress, which was a good kind of stress”.

But nothing could shake their team. They were a well-oiled, well-practised outfit, ready for any scenario, said Yim: “We all sort of knew each other’s thinking, what we were doing and we adjusted [to each other].”

The winning formula

And the secret sauce to their winning formula and saving a life? Communication, communication and more communication.

Winning SIMWars, for these students, provided a glimpse into what it takes to translate textbook knowledge and passion for healthcare into appropriate medical decisions and timely actions, when dealing with life-and-death circumstances where every second matters.

According to Chan, the biggest learning was the importance of effective communication. “We all improved over the 13 sessions, employing closed-loop communication and being precise and summarising and verbalising things that would be important to the team,” he said.

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Apart from the training sessions, the camaraderie and friendships that developed out of mere acquaintances further contributed to the smooth communication in the team.

“I felt that our team had really good synergy with each other. An openness that made it a lot easier to communicate as it wasn’t hierarchical. That lack of barrier made it pretty smooth, and I think that really kind of gave us an edge,” said Fu.

The many faculty members’ willingness to help in training and supporting the team sparked an even bigger motivation to take the gold home—one that didn’t go unnoticed.

“They are very passionate, and I do admire their camaraderie. They really worked together as one. And they were all determined to win,” said Abegail Resus Fernandez, a certified healthcare simulation educator and manager with the Technology-Enhanced Learning and Innovation Department at Duke-NUS, who trained the team together with Wong since day one.

The 17-year Duke-NUS veteran was even more impressed with the progress the team had made. Despite the quantity of training sessions, the fact that they were squeezed into just 12 weeks and crammed a lot of content, could have easily overwhelmed the students, who had to juggle the rigorous demands of medical school while preparing for the SIMWars.

Brian Fu

Brian Fu celebrating the team’s winning moment by capturing this moment of triumph // Credit: Courtesy of Brian Fu

She added: “Everyone is part of the team, you’re not one person doing everything for your patient, you have to involve everyone in your team. So, I think that is their strength and I’d really like to salute this team.”

A training session in the simulation suite // Credit: Duke-NUS

As for Fu, he is just “very proud of our team. It was one of those things where at the end of the day, all those 40 hours of preparation were very much worth it”.

"It’s about being prepared. Simulation gives us the confidence to act decisively, knowing that we’ve trained for it.”
Mr Pierre Yim

Just like his teammates, Yim wanted to do the best for the team. Beyond the SIMWars, such exposure and opportunity to engage with immersive simulation learning has a far-reaching impact for future physicians such as himself.

“I think having intensive training going one level further really helps ingrain in us a sense of confidence and empowerment to actually do something for our patients. I feel confident enough to say something, do something,” said the 35-year-old, who is the oldest team member.

“We were actually talking about this after the competition. My number one comment is that this is not about emergency medicine, it’s about using this as a tool to make you a better physician in whatever discipline you are in,” shared Chan.

For Chan, who sees himself as a future clinician-scientist, taking on this very medical challenge was a once in a medical-school-time opportunity: “I couldn't give up this opportunity. I think it was an incredible learning opportunity.”

"SIMWars isn’t just about emergency medicine—it’s about being a better doctor, no matter what field you enter..”
Mr Wharton Chan

These unique learning opportunities offered through immersive simulation sessions create space for students such as himself and the rest of his team to become even better doctors with immersive opportunities to translate textbook knowledge into action.

“I don't need to commit to the path of emergency medicine to enter this competition. I think that’s very, very important as whatever career path I pursue, emergency medicine is going to be important in some part, so that was why I didn't stop myself,” added Chan.

Safe learning space

At Duke-NUS, immersive simulation sessions are the common denominator that forms an integral part of the four years of medical education. As students progress, they are exposed to increasingly complex medical scenarios, helping them to develop essential skills with great finesse while adapting to their professional identities.

In a fully interactive fashion, students are able to experience guided-medical emergencies and other medical scenarios, thus replicating and amplifying real clinical scenarios of varying degrees of difficulty, involving a patient, doctors and/or an interprofessional healthcare team.

“It’s a preempt to handling real-life patients. Simulation can only do so much, and you can think of a few predictable scenarios, but patients are unpredictable. People are complex. So, the training with immersive simulation prepares you so that you don’t start from scratch, and you know where to proceed from there and build up your skills,” explained Wong, who is also the clinical lead for the immersive simulation-based education at Duke-NUS.

She added: “It is complementary as technology has been introduced such that it allows a safe space to commit mistakes first, so that when we face real patients, we are less likely to repeat those mistakes.”

Briefing for the competing teams on the day of the competition // Credit: Dr Hoe Pei Shan

“I think it’s because of medicine’s nature, which is very serendipitous where you kind of learn depending on what type of patient you happen to come across in the wards. The immersive simulation experience gives you an edge, for instance if you encounter this type of patient, these are all the important things to look out for, so you’re not just thrown into the deep end when it happens for the very first time. You’re not completely lost," shared Fu.

Yim agreed with this assessment. He highlighted how immersive simulation learning served as a confidence booster. “The good thing about simulation is that you can do it over and over again, so it builds confidence. A lot of learning in a controlled environment.”

Doing the same thing over and over again, whether that’s in a simulation or in other parts of medical training, also reinforces the importance of being resilient.

“Perseverance is key because I think it takes you through all the successes and definitely the failures. I think for a lot of people medical school will probably be the first time they will fail a test, or a station in the exam. So, to have the mental fortitude to persevere through all these setbacks is the key quality for any medical student,” said Yim, a former nurse who was inspired by his experience interacting and working with patients and doctors to pursue medicine.

For Yim, emerging victorious from the SIMWars was just the icing on the cake.

“I think my hope is there will be a lot more students who sign up for competitions like SIMWars so that we can have a stronger pool of individuals to choose from and carry on our winning tradition,” said Yim, with a shy smile.

“If we win again, it’s a winning tradition.”