The quality of healthcare varies significantly from one country to another. This variation can be attributed to several factors, including the level of healthcare professionals’ professionalism, which is closely linked to the quality of their education. Medical and healthcare education is unique in its need for students to learn and practice various clinical skills, algorithms, and behaviours for clinical situations. However, it is challenging to ensure these educational experiences do not compromise the quality of healthcare and patient safety. A simulation-based educational (SBE) approach offers a solution to these challenges. However, despite the widespread adoption of the SBE approach in medical and healthcare education curricula; its recognition for its high value among students, educators, and healthcare professionals; and evidence showing its positive impact on reducing risks to both patients and healthcare professionals, there is still an absence of a standardized approach and guidelines for integrating simulations, which includes determining when, how, and to what ex-tent they should be implemented. Currently, there is no regulation on the need for SBE integration in medical and healthcare curricula. However, the framework of this article, based on the results of the analysis of the legal framework, which includes a set of laws, regulations, principles, and standards set by various government, administrations, and authoritative institutions, will determine the fundamental aspects of the integration of the SBE approach that justify and argue the need to (1) incorporate simulation-based education across all levels of medical and healthcare education programs and (2) adhere to certain standards when integrating the SBE approach into medical and healthcare programs. This is an area that needs to be developed with the involvement of legal, health, and education experts.

The competence of healthcare professionals is crucial in ensuring patient safety and the quality of healthcare. Skills are one of the most important aspects of competence, but often health care employers, when assessing the readiness of young professionals, point out that the ability to implement skills in a real work environment are unclear, insufficient and even inadequate.The paradigm shift in education intends bringing skills to the foreground. In order to promote skills management, Rīga Stradiņš University (RSU) already in 2016 started work on the institutional level project “Skills Monitoring System” (hereinafter - SMS), focusing primarily on work and profession specific skills in the field of health care studies.Visible and demonstrable monitoring of skills in education is an innovation. The aim of this article is to analyze and reflect the coherence of the RSU Skills Monitoring System concept with the current principles of education policy development, legal framework and basic principles of higher education pedagogy in skills acquisition and evaluation in health care education, as well as to evaluate the initial results of the newly developed system.In order to achieve the goal, an interdisciplinary, qualitative study was conducted, where analytical and descriptive, inductive, deductive and synthesis research and legal (translation) norm methods were implemented, as well as interviews to evaluate initial results.The results of the research show that the components and solutions included in SMS have been developed in accordance with the legal framework and the main educational guidelines, in accordance with the theoretical concepts of pedagogy. An education approach based on simulation integrated in the acquisition of skills allows to systematically evaluate the amount and quality of theoretical knowledge, to determine the actual level of abilities and to predict the quality of performance and compliance with the real work environment. The management of skills acquisition in Higher Education Institutions should be supported and promoted from the point of view of educators, employees and sectoral professional associations and employers.

In the 21st century, the healthcare sector faces formidable challenges, including the rapid proliferation of medical technology innovations, the extension of life expectancy, and the concurrent trend of ageing within society. Moreover, healthcare grapples with an acute shortage of workforce, accompanied by significant skills gaps and mismatches. The consequences of skills shortages, gaps, and mismatches are profound, potentially impeding the treatment process and compromising healthcare outcomes, thereby jeopardizing both the quality of healthcare and the safety of patients and healthcare professionals alike. These signals underscore the imperative for transformative adjustments within the healthcare sector. Amidst this dynamic landscape, healthcare institutions must cultivate systems and approaches capable of rapid adaptation to evolving circumstances while facilitating future planning and data-driven decision-making. Of paramount importance is the establishment of systems that ensure effective knowledge management for healthcare professionals, identify knowledge and skills gaps, and highlight improvement opportunities. In light of these exigencies, the authors have crafted a conceptual model of human capital management based on skills monitoring and tailored to the healthcare sector. This model encapsulates a human-centric management ethos, seamlessly integrated with a data-driven business strategy within a patient-centric healthcare paradigm. The practical implementation of the Human Capital Management Model would empower healthcare institutions to make informed, data-driven decisions to reach the strategic goals of the institution: ensuring efficient human resource provision with appropriate skill-mix, improving health quality, increasing patient and healthcare professional safety, and the sustainable use of financial resources.

This policy insight outlines Latvia’s national strategy for integrating simulation-based education into all levels of medical and healthcare education by 2027. It is framed as a direct response to the 2024 Global Consensus Statement on Simulation-Based Practice in Healthcare, operationalizing its recomme ndations within a national policy context for Latvia. Grounded in international and national standards—including WHO guidance, EU directives, and principles of healthcare safety and education quality—the strategy promotes simulation as a transitional and indispensable phase between theoretical instruction and clinical practice. The strategy emphasises structured collaboration among universities, professional associations, healthcare providers, and government bodies. It sets out a governance and resource model for simulation-based learning environments, ensuring quality, sustainability, and alignment with ethical and professional standards. By embedding simulation-based education into undergraduate, postgraduate, and continuing medical education, Latvia aims to enhance healthcare professionals’ clinical competence, reduce preventable medical errors, and improve patient outcomes. The approach supports deliberate practice, facilitates safe and realistic training conditions, and strengthens the preparedness of healthcare workers for both routine and complex clinical scenarios. The strategy also calls for standardised quality-assurance mechanisms, accreditation procedures, and integration into national regulatory frameworks. This national roadmap aims to establish Latvia as a regional leader in simulation-based healthcare education, improving not only the safety and efficiency of healthcare services but also public trust and professional development. As such, the strategy serves both as a practical implementation plan and a model for countries pursuing similar goals.

Background and Objectives: Health systems increasingly require workforce governance approaches that move beyond formal qualifications and make physician skills more visible for planning, education, quality management, and resource allocation. However, evidence remains limited on how physician skill information is organisationally documented and used within hospitals, particularly in small health systems. This study examined how information on physician skills is organisationally documented, interpreted, and used for workforce governance across all Latvian university hospitals, and identified organisational, cultural, and digital barriers to systematic skills monitoring. Materials and Methods: A qualitative, exploratory, multi-institutional design was adopted. Semi-structured interviews were conducted with 12 stakeholders from human resources, education, quality, and finance across all three Latvian university hospitals. Data were analysed using reflexive thematic analysis, with reporting guided by COREQ and SRQR. Results: Eight interrelated themes were identified across three domains. Current practices were fragmented and primarily focused on formal qualifications rather than verifiable practical skills. Internally delivered education was partially documented, whereas externally acquired skills remained largely outside organisational systems. Skill gaps were usually identified reactively through incidents, complaints, or managerial observation. Training needs were determined through decentralised channels, and skill assessment depended heavily on local leadership judgement. Participants also highlighted financial blind spots, weak digital infrastructure, governance ambiguity, cultural resistance, and limited staffing capacity as barriers to implementation. At the same time, respondents consistently reported that improved skill visibility could support strategic workforce planning, targeted education, patient safety, better financial justification, and greater organisational transparency. Conclusions: Latvian university hospitals appear to recognise the organisational value of physician skill visibility but currently lack integrated systems for capturing and using such information systematically. The findings support the need for a context-sensitive, phased approach to skills-based workforce governance and inform a data-informed conceptual framework (Three-Layer Skills Governance Model) for aligning regulatory expectations, organisational processes, and individual skill records in small health systems.