The core idea behind the 4C/ID is that person learns when s/he is guided through a series of simulations of the whole real-world problem situation (called learning tasks). For example, to learn how to manage the situation of communicating with patients, the nurse could start with a series of simulated role-plays. Then the nurse could gradually move to more complex situations, for example, communicating with patients about elementary health issues and reaching a situation with the most challenging condition (speaking about complex and unknown diseases).
These series of simulations of real-world problems are the heart of the program. When a student is involved in solving such problem simulations, s/he uses the system of competencies, skills, knowledge, and attitude in a particular condition.