Advances in simulation (London, England)最新文献

{"title":"Rethinking real-time learning in debriefing: liminality, microgenesis, and semiotic borders.","authors":"José Luis Medina, Gabriel Hervas, Isaac Calduch, Patricia Silva, Esther León","doi":"10.1186/s41077-026-00436-9","DOIUrl":"10.1186/s41077-026-00436-9","url":null,"abstract":"<p><p>We offer a new interpretive framework to analyze and explain learning processes in real time during discursive interactions in clinical simulation, especially in debriefing. First, we question the computational metaphor of the mind, where the mind is conceptualized as a closed system that processes symbols linearly, typical of traditional cognitivist learning approaches with profound practical implications over debriefing. This approach is insufficient to explain the complexity of learning in situated, uncertain, and dynamic contexts such as debriefing. During debriefing, participants do not simply remember data or assimilate external conceptual structures ready to be used, but rather undergo more complex processes. They experience discontinuities, oscillations, and ambiguities in their thinking, while negotiating tensions and facing moments of cognitive and emotional instability. To capture this dynamic, we need a richer, more flexible, and more responsive approach to lived experience.Given these limitations, new interpretative proposals are emerging that seek to explain learning in debriefing by describing both the logic behind the configuration of the participants’ interpretive frames and the intra-subjective and intersubjective dynamics that modulate them in real time. The goal is to provide theoretical models that help us to elucidate a phenomenon that cannot be understood through linear schemes or unidirectional causalities, as it unfolds in the non-linear flow of brief temporal sequences loaded with meaning.To this end, we present a new interpretive framework in which we have integrated three fundamental theoretical concepts: liminality, microgenesis, and semiotic border. Although these concepts come from different theoretical traditions, we have united them in a conceptual framework that allows us to understand how frames of reference are configured during debriefing, without reducing them to fixed or pre-established conceptual structures, preserving their dynamic, contingent, and situated nature. Each of these concepts addresses, from different theoretical traditions, how meanings are constituted under conditions of structural instability and on very short time scales.Finally, we present empirical indicators that allow us to identify these complex and “elusive” phenomena in practice, providing guidance for supporting debriefers’ practice in noticing and interpreting learning, and a key methodological tool for research analysis as an emerging qualitative coding scheme.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":"11 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13067597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147655493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Moving beyond projects: a logic model evaluation of an established translational simulation program.","authors":"Andrew Petrosoniak, Aradhana Tewari, Lindsay Beavers, Nivetha Chandran, Kristen Sampson, Christine Léger, Nazanin Khodadoust, Ryan Brydges","doi":"10.1186/s41077-026-00434-x","DOIUrl":"10.1186/s41077-026-00434-x","url":null,"abstract":"<p><p>BACKGROUND: Advancing beyond a sole focus on individuals’ and team’s clinical skills training, translational simulation uses simulation-based methodologies to diagnose healthcare system gaps and inform targeted quality and safety improvements. While promising conceptually, few reports exist on how to build sustainable, system-level translational simulation programs in hospital settings. METHODS: We applied a logic model evaluation framework to assess four-years of activity in Unity Health Toronto’s established translational simulation program. Researchers not directly involved in the translational simulation program interviewed internal team members and program partners who had utilized the program. The interviews focused on the processes associated with project selection, implementation, and outcome collection. The research team used an iterative, team-based consensus approach to develop a fulsome logic model to richly describe the observed impacts and challenges of the program. RESULTS: Our analysis reflected experiences of 10 internal team members, and 14 program partners who contributed to 11 completed projects. We found that early collaboration during project intake was critical, but sometimes slowed perceived progress. Program members described a regular need to establish a shared conceptual understanding and clear roles at the outset with each program partner. Mutual adaptability between the simulation team and partners was reported as a defining factor for successful project implementation. Program outputs primarily consisted of simulation team generated reports, which generally met partner expectations; however, several partners desired more detailed, actionable analyses. Mid- to long-term outcomes varied based on project goals, including changes to clinical workflows, policy revisions, improved team performance, and enhanced patient outcomes. CONCLUSIONS: Grounded in refined claims for each logic model element, this evaluation provides transferable principles and data-driven recommendations for implementing and sustaining translational simulation programs. Our findings informed local program refinements while also producing strategies that can be applied broadly to translational simulation programs: 1) Flexible engagement tailored to partner needs and context 2) Clear definitions of simulation modalities, milestones, roles, objectives, and deliverables, 3) Structured communication throughout all project phases, and 4) Consistent follow-up to ensure translation of insights into clear returns on investment, and sustained system change. </p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13170001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147610803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"School nurse preparedness for critical events - a multi-modal simulation training pilot.","authors":"Samuel Gowan, Marcie Gawel, Barbara M Walsh","doi":"10.1186/s41077-026-00432-z","DOIUrl":"10.1186/s41077-026-00432-z","url":null,"abstract":"<p><p>School-based emergencies, notably school shootings, are emotionally taxing events for school nurses (SNs). As frontline healthcare providers, SNs must rapidly assess injuries, coordinate emergency response, support the school community, communicate with families and emergency medical services (EMS), and manage their emotions. Yet most SNs receive minimal standardized training to manage mass-casualty incidents effectively. In the United States, SNs in the Boston Public School System (BPSS), have experienced increasing penetrating trauma, prompting leadership to pursue targeted educational solutions. Although a U.S. prominence, school violence remains a global concern, emphasizing its worldwide relevance and underscoring the international need for school-based emergency preparedness. In response, an interprofessional team developed a tailored, integrated emergency curriculum informed by a collaborative needs assessment. Recognizing that medical crises occur more frequently than shootings, the curriculum intentionally addressed both traumatic and medical emergencies. The multimodal program prepared SNs to bridge care until EMS arrives and included two hours of interactive workshops followed by two realistic multi-victim simulations. Interprofessional faculty facilitated skills training, simulation, and debriefing while assessing adherence to evidence-based practices. Pilot findings revealed gaps in leadership, communication, triage, CPR/PALS initiation, and task delegation. Strong engagement led BPSS leadership to request continuation in 2024, with returning participants demonstrating improved command presence, delegation, and closed-loop communication. Next steps include formal program evaluation using validated assessment tools and expansion to incorporate disaster triage protocols and preparedness. Given global lack of standardized emergency training for SNs, this innovative curriculum offers a scalable, adaptable, impactful model for strengthening school-based emergency readiness worldwide.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13217955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147576617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of simulated participant professional performance in health professional education: a scoping review.","authors":"Sergio Andres León-Ariza, Elizabeth Fernanda Ríos-Villarreal, Juan Yepes-Núñez, Sebastian Castaño-Duque, Sandra X Jaramillo-Rincón","doi":"10.1186/s41077-026-00422-1","DOIUrl":"10.1186/s41077-026-00422-1","url":null,"abstract":"<p><p>BACKGROUND: Simulated participants (SPs) are crucial in health professional education, offering a controlled environment for students to develop clinical, diagnostic, and communication skills. However, limited research focuses on the structured evaluation of SP competencies, a key factor for maintaining educational quality. This scoping review aims to identify and categorize the strategies, tools, and instruments used to assess simulated participants’ (SPs) performance in health professional education; examine how these approaches assess and provide feedback on SP performance; and highlight gaps in the current research and practice regarding the assessment of SPs. METHODS: A comprehensive literature search was conducted in Medline, EMBASE, and LILACS databases from 1990 to April 2025. Eligible studies included SP performance assessments at all levels of Miller’s pyramid (knowledge, application, demonstration, and action). Both qualitative and quantitative data were extracted and categorized based on the types of competencies assessed (communication, role accuracy, feedback) and the tools’ validation status. Descriptive statistics were employed to summarize the findings. RESULTS: Out of 7724 articles screened, 52 studies met the inclusion criteria. Most studies (75%) did not focus exclusively on SP assessment but included it in broader educational outcomes. Commonly used assessment tools were rating scales (29%) and self-perception surveys (26%), primarily measuring role-playing accuracy and communication skills. Only 40% of these tools had undergone formal validation. Additionally, the studies often lacked consistency in the criteria used for evaluating SP performance, with a heavy focus on communication and realism. At the same time, other competencies, such as providing structured feedback and adherence to case protocols, were less frequently assessed. Tools that evaluated SP feedback delivery were found in only 21% of the studies, despite the recognized importance of this skill for effective student learning. Furthermore, several studies highlighted the need for continuous SP training and reassessment to maintain high-quality performance. CONCLUSIONS: This review identifies significant gaps in the comprehensive evaluation of SP competencies, particularly regarding the validation and standardization of assessment tools. Future research should prioritize the development of robust, validated frameworks that assess a broader range of SP skills, including feedback delivery and adherence to simulation protocols. Such advancements are essential to enhance the reliability and educational impact of SPs in health education. </p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13147732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147534995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing under-appreciated risk in healthcare simulation.","authors":"Paul O'Connor, Angela O'Dea, Dara Byrne","doi":"10.1186/s41077-026-00423-0","DOIUrl":"10.1186/s41077-026-00423-0","url":null,"abstract":"<p><p>Our experience of running a simulation centre reveals specific areas of risk that are not widely discussed in the simulation literature- namely the potential for physical harm and threats to the viability and continuity of simulation programmes. Physical harm can occur in unanticipated ways and therefore it is imperative that simulationists acknowledge these risks, and mitigate against them, through robust risk management processes. Key operational risks to the viability and continuity of programmes are financial and human resources. The design and delivery of simulation activities requires a team of individuals who complement each other in terms of administrative, simulation and clinical expertise. There is also a need to ensure that the loss of a key member of the team does not threaten the continuity of the delivery of the simulation programmes. Simulation based education (SBE) is an effective approach to the education and training of healthcare providers. However, it is vitally important to be aware of and manage the safety risks of the activities and ensure human resources are available to ensure the viability and continuity of a simulation facility and programmes.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":"11 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13023144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147522862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Teaching sustainability through disaster simulation: A framework for planetary health education.","authors":"Nicole Petsas Blodgett, Valerie K Sabol, AnnMarie Lee Walton","doi":"10.1186/s41077-026-00433-y","DOIUrl":"10.1186/s41077-026-00433-y","url":null,"abstract":"<p><p>BACKGROUND: Climate‑driven disasters are increasing in frequency and severity, creating prolonged recovery periods and widening existing health inequities. As extreme weather events intensify, healthcare professionals must be prepared to mitigate risks, adapt to evolving conditions, and understand how environmental degradation influences population health. Simulation‑based education provides a safe, flexible platform for introducing these concepts while fostering core competencies in disaster preparedness. APPROACHES: This article outlines strategies for integrating planetary health and sustainability principles into climate‑driven disaster simulations across preparedness, response, and recovery phases. Approaches include using low‑waste modalities such as tabletop, hybrid, and digital simulations; repurposing expired non‑sterile supplies; and designing scenarios that explicitly incorporate resource stewardship. We distinguish between sustainability as curricular content (what learners are taught) and sustainability as operational practice (how simulations are conducted), arguing that both must be addressed to reduce the environmental footprint of training while advancing climate fluency. Embedding sustainability objectives into learning outcomes, debriefings, and evaluation metrics enables learners to examine both their clinical decision‑making and the environmental implications of their actions. The article also highlights opportunities to incorporate climate and sustainability concepts across undergraduate and graduate curricula. These strategies promote systems thinking, strengthen interprofessional collaboration, and support the development of clinicians who understand the links between climate change, health disparities, and responsible use of healthcare resources. CONCLUSION: By integrating sustainability, mitigation, and adaptation principles into disaster simulations, educators can prepare future healthcare professionals to respond effectively to climate‑driven crises while reducing the environmental impact of training itself. This intentional approach strengthens disaster readiness and cultivates a culture of environmental responsibility across health professional education This dual approach reframes disaster simulation as both clinical preparation and climate action within health professions education. </p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13137609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147516711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Education that Empowers: A critical realist evaluation of a novel incivility-focused immersive simulation.","authors":"Katherine Ralston, Valerie Rae, Ed Mellanby, Jane Hislop, Victoria Tallentire","doi":"10.1186/s41077-026-00413-2","DOIUrl":"10.1186/s41077-026-00413-2","url":null,"abstract":"<p><p>BACKGROUND: When we experience incivility, or rudeness, our performance suffers, negatively impacting patient safety. Immersive simulation-based education (SBE) has been under-explored as an educational strategy that may empower individuals to challenge incivility. Psychological empowerment was conceptualised by Spreitzer as four cognitive domains (meaning, competence, self-determination, and impact) that influence motivation and an active orientation towards work. We aimed to explore the mechanisms underlying the influence of incivility-based immersive SBE on the experiences of medical registrars when facing workplace incivility. METHODS: We situated this study within a critical realist paradigm, a philosophical stance which aims to provide explanatory power to understanding the mechanisms that drive social reality. We conducted semi-structured interviews with 11 medical registrars at least four months after an incivility-based immersive simulation scenario. Interviews focused on participants’ experiences and reflections of workplace incivility, and the potential impact of their simulation experience. Data were analysed using template analysis, utilising Spreitzer’s theory of psychological empowerment as the guiding framework. RESULTS: Incivility-based SBE stimulated powerful reflection relating to the cognitive domains of psychological empowerment. Meaning encompassed a sense that civility was important, with mechanisms of awareness and advocacy across boundaries. Competence referred to having the skills to manage incivility, with mechanisms of mindful response, self-regulation and perspective taking. Self-determination related to having autonomy when experiencing incivility, with mechanisms of identity formation and risk assessment. Impact was re-conceptualised as transfer, referring to the socio-structural mediators of transfer to practice, with mechanisms of socio-political support, participatory culture, and systems. CONCLUSIONS: We highlight the potential role of immersive SBE as a powerful tool to explore workplace incivility. SBE may influence behavioural change through provoking reflection related to psychological empowerment. We explore SBE as an influencer of the nuanced risk assessment that occurs when individuals face incivility. This framework of psychological empowerment has utility in designing effective SBE focused on relational aspects of work. </p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":"11 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13001293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147488679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stop play: key takeaways on physical safety awareness in healthcare simulation education.","authors":"Tatiana Lubin, John Cruz, Komal Bajaj, Michael Meguerdichian, Katie Walker","doi":"10.1186/s41077-026-00421-2","DOIUrl":"10.1186/s41077-026-00421-2","url":null,"abstract":"<p><p>Healthcare simulation is a practice used to train healthcare workers and refine their clinical and behavioral skills. This practice is underpinned by its safe learning environments, where participants can learn from their mistakes without fear of patient harm. A safe learning environment in simulation education encompasses physical and psychological safety. To date, physical safety has rarely been discussed in the literature. This criterion aims to act as a catalyst to motivate situationists to think explicitly about physical safety when creating and conducting simulation experiences. Drawing from both experience and evidence base, this paper looks to build safety awareness, and guidance for developing and implementing explicit physical simulation safety protocols & best practices, as well as outline physical simulation safety training to prevent adverse events during simulation activities. We believe that prevention is better than a cure.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13107706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147470376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simulosophists: evolving the professional identity of simulation practitioners.","authors":"Griselda Gonzalez-Caminal, Laura Castillejos-Gallego, Carmen Gomar-Sancho","doi":"10.1186/s41077-026-00417-y","DOIUrl":"10.1186/s41077-026-00417-y","url":null,"abstract":"<p><p>Simulation educators frequently cultivate psychological safety and reflective practice within simulated environments, yet these same values often fail to translate into their broader professional contexts as members of teaching department or healthcare teams. This inconsistency-between what is modelled in simulation and what is lived in everyday work-reveals a deeper issue of professional dissonance that is not fully addressed by existing simulation standards and codes of ethics, which largely focus on conduct within educational activities rather than in wider workplace cultures. Moreover, many simulation practitioners \"wear multiple hats,\" simultaneously inhabiting roles as clinicians, educators, and leaders, which can blur boundaries and expose tensions between espoused values and organizational hierarchies. This conceptual paper proposes the concept of the simulosophist-a simulation practitioner who not only teaches but lives on the foundational principles of simulation: ethical integrity, reflection, and psychological safety-across roles and contexts-and argues that the evolution toward this identity requires coordinated action at individual, institutional, and disciplinary level. The simulosophist bridges the gap between simulated and real-world practice, modeling coherence across roles and contexts. By embracing this multi-level perspective and this proposed professional identity, simulation practitioners can advance simulation not merely as a pedagogy, but as a culture of integrity and professional practice that is consistently enacted beyond the simulation room.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":"11 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12990652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147470336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adapting the TeamSTEPPS team performance observation tool for dyadic interprofessional VR simulations (vTPOT): a multi-step validation study.","authors":"Marie Lehmann, Stefanie Hinz, Alexander Zamzow, Jan Mikulasch, Horst Poimann, Joy Backhaus, Marvin Mergen, Tobias Mühling","doi":"10.1186/s41077-026-00431-0","DOIUrl":"10.1186/s41077-026-00431-0","url":null,"abstract":"<p><p>BACKGROUND: Interprofessional teamwork is a key determinant of patient safety in medical emergencies, yet its structured assessment remains resource-intensive and is rarely integrated into undergraduate curricula. Immersive virtual reality (VR) offers scalable environments for training and assessing teamwork but introduces contextual constraints such as dyadic team structures, avatar-mediated interaction, and limited non-verbal cues. Established assessment tools, including the Team Performance Observation Tool (TPOT), have not been systematically adapted or validated for these VR-specific conditions. METHODS: We adapted the TPOT for dyadic VR-based emergency simulations (vTPOT) through expert-driven item revision, development of behavioral anchors, and a two-round modified Delphi process with 15 interprofessional experts. No new VR-specific items were introduced, instead, items that could not be meaningfully observed in immersive VR were removed or consolidated to preserve conceptual stability. Five trained raters independently evaluated 21 VR simulation videos from interprofessional dyads (medical and nursing students) using both the original TPOT and the vTPOT. Following Kane’s argument-based validation framework, we examined evidence for scoring (content validity, association with the original TPOT), generalization (internal consistency, interrater reliability), extrapolation (associations with teamwork perceptions and objective medical performance), and implications (written qualitative responses from raters) on potential unintended effects and implications for feedback and assessment). RESULTS: The final vTPOT comprises 15 behaviorally anchored items across five teamwork domains. Internal consistency was high (Cronbach’s α = 0.92), and interrater reliability was moderate to substantial (intraclass correlation coefficient = 0.68). vTPOT scores showed strong convergence with the original TPOT (r = 0.92) and with participants’ teamwork perceptions (T-TPQ; ρ = 0.64 and 0.80 for nursing and medical students, respectively). Higher vTPOT scores were positively associated with objectively measured medical performance in VR scenarios (r = 0.54). Raters reported that the vTPOT supported structured observation and feedback, while also highlighting context-specific limitations and potential unintended effects. CONCLUSIONS: The vTPOT appears to be a feasible and reliable instrument for assessing interprofessional teamwork in dyadic VR simulations within the studied context. Initial validity evidence supports its intended use for low-stakes assessment and research. Further studies are needed to examine construct structure and extend validation to additional contexts, populations, and outcomes to strengthen the overall validity argument. </p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13023181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147445995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}