| Obstacle1: Trainer awareness to MHS | P Value | |
| Lack of knowledge where simulation can be applied | 56(64.4%) | |
| Lack of knowledge of benefit of simulation | 41(47.1%) | |
| Assume simulation is not suitable | 24(27.6%) | |
| Heard of negative experience from others | 8(9%) | |
| Not encouraged by their superiors and limited simulation centres | 1(1.14%) | |
| MHS can improve outcome of patient care | 85(97.7%) | < 0.001 |
| MHS can’t improve outcome of patient care | 2(2.3%) | |
| MHS can improve physician skills | 84(96.6%) | < 0.001 |
| MHS can’t improve physician skills | 3 (3.4%) | |
| MHS can improve physician medical knowledge | 82(94.3%) | < 0.029 |
| MHS can’t improve physician medical knowledge | 5(5.7%) | |
| MHS can improve team work | 84(96.6%) | <0.001 |
| MHS can’t improve team work | 3(3.4%) | |
| Recommend skills simulation courses to be repeated frequently through the year | 83(95.4%) | < 0.006. |
| Didn’t recommend skills simulation courses to be repeated frequently through the year | 4(4.6%) | |
| Obstacle2: Obstacles of skills, organizational and technical limitations for the use of MHS | ||
| Lack of time to attend or create simulation models | 58(66.6%) | |
| Lack of staff skills in simulation development | 42(48.3%) | |
| Lack of knowledge on how to create simulation courses | 41(47.1%) | |
| Lack of equipment | 39(44.8%) | |
| Time | 1(1.14%) | |
| Obstacle3: Cost limitation of MHS | ||
| Simulation courses as main obstacle | 58(66.6%) | |
| Software, hardware and equipment | 55(63.2%) | |
| Staff trainers | 29(33.3%) | |