Healthcare systems across the world are facing unprecedented complexity. Managers must balance rising demand, workforce shortages, financial constraints, and the growing need to safeguard staff well-being — all while maintaining high standards of care. Within this challenging landscape, innovative learning approaches are becoming essential to prepare future healthcare leaders.
One such approach took shape at SDA Bocconi School of Management, where students of the Master of International Healthcare Management, Economics and Policy (MIHMEP) recently participated in the APOLLO 2028 Business Game. Designed as an interactive simulation grounded in real-world challenges, the experience offered participants a unique opportunity to explore the dynamics of healthcare resilience and decision-making in complex organizational environments.
A European Initiative Focused on Healthcare Resilience
The APOLLO 2028 project is a four-year Horizon Europe initiative bringing together universities, research centres, and healthcare institutions from across Europe and beyond. With partners spanning eight countries and two continents, the project aims to advance understanding of resilience within healthcare organizations — from the individual professional to the broader system level. At its core, APOLLO 2028 investigates how healthcare professionals and organizations respond to increasing pressure, uncertainty, and change. The project combines data collection, modelling, and interdisciplinary research to develop evidence-based strategies that support mental health, well-being, and sustainable organizational performance. Beyond academic research, the initiative places strong emphasis on translating insights into practical tools and interventions. This action-oriented approach ensures that findings are not confined to theoretical discussions but instead inform tangible improvements in healthcare management practices.
Learning by Doing: The APOLLO 2028 Business Game
The Business Game, designed by the ELTE University team from Hungary and hosted at SDA Bocconi (Italy)represented a key milestone in this effort. Rather than traditional classroom teaching, participants engaged in an immersive simulation designed to replicate the complexity of managing a hospital department. Students worked in small teams, each assuming the role of a hospital management group operating within a fictional healthcare system known as “APOLLOland.” Across multiple rounds of gameplay, they were required to make strategic decisions related to staffing, care quality, operational pressures, and financial performance. These decisions were evaluated through indicators aligned with the Quadruple Aim framework — a model widely used in healthcare management that focuses on four interdependent objectives: improving population health, enhancing patient experience, controlling costs, and promoting staff well-being.
By placing participants in realistic decision-making scenarios, the simulation encouraged them to confront the trade-offs inherent in healthcare leadership. Choices that improved financial efficiency, for example, could influence workforce satisfaction or patient outcomes, highlighting the delicate balance managers must maintain.
Iterative Decision-Making and Reflective Learning
A distinctive feature of the simulation was its structured learning cycle. Each gameplay round was followed by debriefing sessions where teams analysed their strategies, compared outcomes, and discussed alternative approaches. These collective reflections allowed participants to connect their decisions with broader organizational dynamics. Such iterative processes mirror real healthcare environments, where leaders must constantly adapt to evolving conditions and evaluate the consequences of their actions. Through guided discussions, students gained deeper insight into how managerial choices can influence resilience at individual, team, and system levels.
The experience also reinforced the importance of collaboration and interdisciplinary thinking. By working in teams, participants explored how diverse perspectives contribute to more robust decision-making — a skill that is increasingly critical in modern healthcare settings.
Understanding Complexity Through Modelling and AI
In addition to gameplay, students were introduced to the underlying methodologies used to design the simulation itself. Sessions explored the basics of agent-based modelling — a computational approach that represents interactions between individuals and organizations to understand complex systems. This behind-the-scenes perspective provided valuable insight into how simulations can capture the dynamic nature of healthcare environments. By observing how variables such as staffing levels, workload, or policy decisions influence outcomes, participants gained a deeper appreciation of the systemic forces shaping healthcare performance.
The programme also highlighted the growing role of artificial intelligence in managerial decision support. As healthcare systems increasingly rely on data-driven tools, future leaders must understand both the potential and the limitations of AI-enabled technologies. By integrating discussions on AI within the simulation experience, APOLLO 2028 connects educational innovation with the evolving digital landscape of healthcare management.
Co-Creation with End Users
Another distinctive aspect of the APOLLO 2028 Business Game is its collaborative development process. Students did not participate solely as learners; they also acted as end users providing structured feedback on the simulation’s realism, usability, and educational value.
This co-creation approach reflects the broader philosophy of the project, which emphasizes collaboration between researchers, practitioners, and stakeholders. Feedback gathered during the session will inform further refinements of the tool as it is deployed across other partner institutions. By involving participants directly in the development process, the initiative ensures that educational tools remain relevant, user-friendly, and grounded in real-world needs. It also fosters a sense of ownership among learners, encouraging them to engage more deeply with the challenges explored during the simulation.
Preparing Leaders for the Future of Healthcare
The healthcare sector is undergoing rapid transformation, driven by demographic change, technological innovation, and evolving societal expectations. In this context, resilience has emerged as a key concept — not only for organizations but also for the professionals who sustain them.
Initiatives like APOLLO 2028 highlight the importance of preparing future managers to navigate uncertainty with confidence and adaptability. By combining rigorous research with experiential learning, the project contributes to a new generation of healthcare leaders equipped to balance quality, sustainability, and human well-being.
The Business Game demonstrated how simulations can serve as powerful learning environments, enabling participants to experiment with strategies, understand systemic interactions, and develop critical thinking skills. These competencies will be essential as healthcare systems continue to evolve in response to global challenges.
The Broader Impact of the APOLLO 2028 Project
While the simulation at SDA Bocconi focused on education, its implications extend far beyond the classroom. Insights generated through APOLLO 2028 research are expected to inform policy discussions, organizational practices, and future training programmes across Europe. By investigating resilience at multiple levels — individual, team, and organizational — the project contributes to a holistic understanding of how healthcare systems can remain effective under pressure. Its international collaboration ensures that lessons learned reflect diverse contexts and perspectives, strengthening the relevance of its outcomes.
Moreover, the initiative underscores the role of European research programmes in fostering innovation and collaboration. Through Horizon Europe funding, APOLLO 2028 brings together academic institutions, hospitals, and policy stakeholders to address one of the most pressing challenges facing healthcare today: how to create systems that are both efficient and humane.
Looking Ahead
As the APOLLO 2028 project progresses, the Business Game will continue to evolve, incorporating feedback from participants and expanding its application across partner sites. Future iterations may integrate new scenarios, advanced modelling techniques, and additional learning modules to further enhance its impact. For students, educators, and healthcare professionals alike, the simulation represents a glimpse into the future of management education — one where digital tools, interdisciplinary collaboration, and real-world challenges converge to create meaningful learning experiences.
Ultimately, initiatives like APOLLO 2028 demonstrate that resilience is not merely a theoretical concept but a skill that can be cultivated through practice, reflection, and innovation. By investing in new educational approaches and fostering collaboration across disciplines, the project contributes to building stronger healthcare systems capable of meeting the demands of tomorrow.
