Population cancer screening involves complex decisions about who should be screened, which tests should be used, and how limited resources should be allocated. These decisions require balancing potential benefits with possible harms, including false positives, false negatives, and unnecessary follow-up investigations. Supporting students to understand these trade-offs can be challenging in traditional teaching contexts, where screening concepts are often introduced theoretically and students have limited opportunities to explore how different decisions influence outcomes.

This practitioner presentation describes the development of an interactive digital simulation designed to place students in the role of decision-makers responsible for designing a screening strategy for a hypothetical population. During an online teaching session, students interact with the simulation by selecting key parameters, including the screening test, available funding for screening, and eligibility criteria such as age, sex, and selected risk factors.

Based on these choices, the simulation generates a report summarising outcomes across both screened and unscreened populations. The report includes estimates of true positives, false positives, false negatives, and true negatives. Students then use this report as the basis for a summative assignment in which they analyse the outcomes of their screening strategy and reflect on the implications of their decisions.

By allowing students to experiment with different screening scenarios and observe how their choices influence outcomes, the simulation supports exploratory learning and encourages critical reflection on the complexities involved in designing population screening programmes. The presentation will outline the design of the simulation, its integration into teaching and assessment, and reflections on its use in supporting student engagement with screening decisions.