Background: High-risk industries have applied the study of human factors (HF), to improve safety and outcomes.The study of HF emphasizes the importance of optimizing the interaction of humans with the technology with which they work.Since healthcare is increasingly relying on advanced technologies, HF is becoming more important as a mechanism to ensure optimal outcomes, efficiency and patient safety.In areas such as oncology where healthcare teams function to interpret and apply technology for patient care, optimizing HF is necessary to ensure the best patient outcomes.Methods: Simulation is a tool that can be used to test, train and teach, and is now recognized as an important aspect of medical education.Simulation can be designed to incorporate HF thereby strengthening the educational experience.We designed a simulation-training course to teach healthcare teams how to recognize complications and adverse outcomes in the oncology setting.We reviewed 631 close case files identifying cases where cancer patients had adverse outcomes.Simulations were designed that represented the environment and situations of the original cases.Each simulation was repeated 4 times.All simulations were recorded.Debriefing was done after each simulation.Results: In 50% of simulations the adverse outcome was repeated, but in 50% the test subjects made decisions that would be predicted to avoid the adverse outcome.The simulations revealed weaknesses in systems that could be responsible for adverse outcomes.Debriefing allowed for identification of areas where systems and HF could be improved.Results were used to design systems changes and education for healthcare teams to optimize patient care.Conclusions: HF is increasingly important in healthcare because of technology and the importance of healthcare teams in providing patient care.Simulation can demonstrate system weaknesses that may adversely affect patient care.Weaknesses can take several forms including Human Factors and identifying these allows for systems changes to improve safety and outcomes.Simulation can be used to test systems changes to determine if they are effective prior to applying in the actual healthcare setting.