Virtual simulation as a catalyst for equitable and authentic interprofessional learning

Abstract

Background

Interprofessional education (IPE) is essential for preparing health sciences students for collaborative practice, yet its implementation remains constrained by geographical dispersion, scheduling conflicts, and variability across clinical placements. Advances in virtual simulation technologies including high-fidelity virtual environments and artificial intelligence (AI)-enabled analytics might offer new solutions to address these structural barriers. This study aimed to explore students’ experiences of virtual simulation as a strategy to overcome siloed teaching and support the development of interprofessional competencies within health sciences education.

Methods

A qualitative, descriptive, exploratory, and contextual design was employed. Between January and June 2024, four online semi-structured focus group interviews were conducted via Microsoft Teams with 29 purposively sampled senior undergraduate students from five health science disciplines. An independent external qualitative researcher facilitated the interviews using a central open-ended question and targeted probes aligned with the study objectives. Sessions were audio-recorded, transcribed verbatim, and analysed using the Matrix Building Framework described by Miles, Huberman, and Saldaña. Trustworthiness was ensured through methodological triangulation, peer debriefing, independent coding, and an audit trail consistent with Lincoln and Guba’s criteria.

Results

Analysis yielded two overarching themes with four subthemes. At a system level, virtual simulation ensured accessible and equitable, interprofessional collaboration by reducing geographical and scheduling barriers, standardising learning experiences, and improving administrative efficiency through central scheduling. At a learner level, virtual simulation supported personalised role development, psychological safety, and professional confidence through adaptive scenario design, intentional leadership role allocation, and behaviour-anchored feedback. Participants reported that AI-supported analytics enhanced debriefing quality and enabled focused reflection on communication and teamwork behaviours.

Conclusions

Virtual simulation acts as an infrastructure supporting two complementary purposes for IPE, simultaneously addressing systemic access and equity challenges while supporting individual learner development. When aligned with adaptive pedagogy, psychologically safe facilitation, and validated assessment frameworks, virtual simulation for IPE can be equitable, authentic, and scalable. These findings have implications for curriculum design, faculty development, and institutional investment in sustainable virtual simulation platforms.

Supplementary Information

The online version contains supplementary material available at https://doi.org/10.1186/s12909-026-09773-9.

Background

Interprofessional Education (IPE), as promoted by the World Health Organization (WHO), takes place when individuals from two or more professions learn “about, from, and with each other to enable effective collaboration and improve health outcomes” [1]. Despite its recognised importance, implementation of IPE in higher education institutions faces significant logistical hurdles [1–3]. These hurdles include the difficulty of coordinating schedules and curricula across different health sciences programs, high personnel and resource requirements, and challenges of reconciling distinct professional cultures [3–5]. These challenges often result in a scenario where students from various health sciences programs learn in parallel, akin to “building a sandcastle all by themselves,” rather than engaging in meaningful collaborative practice [1, 5, 6].

Virtual simulation has been identified as one of the emerging and innovative pedagogical tool that may help address these persistent challenges [1]. Virtual simulation provides health sciences students with safe and supportive learning environments that authentically replicate clinical practice, allowing them to develop essential skills in communication and teamwork without the constraints of physical location [2, 7, 8]. This modality includes a spectrum of technologies, from high-fidelity simulators that mimic real-world situations to immersive virtual reality (VR) environments and online discussion platforms, all of which create opportunities for interprofessional interaction [9, 10].

The primary advantage of virtual simulation is its capacity to transcend geographical and logistical silos, thereby increasing the accessibility of IPE. This is particularly crucial for training a healthcare workforce capable of serving rural and geographically isolated populations, who often experience disparities in behavioural health outcomes and access to care [11]. A 2025 research study involving medical and pharmacy students demonstrated that virtual simulations for IPE provide “comparable preparation in interprofessional team functioning and performance” as opposed to traditional, in-person simulations [12]. This finding indicate that virtual simulation platforms are a viable and effective method for delivering IPE, effectively mitigating barriers to rural workforce development.

Virtual simulation is also an effective tool in for developing essential interprofessional competencies. Research indicated that virtual simulation for IPE can promote professional identity development by helping students understand their roles within the healthcare team and recognise their own value and that of other professions [1, 13, 14]. Another research study, employing the team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) framework trained and assessed teamwork dimensions such communication, leadership, and situation monitoring within VR environments. The results indicated sustained improvements in both objective performance and subjective team perceptions [15].

The scalability and flexibility of virtual simulation platforms are some of the key drivers for the adoption of these platforms in higher education institution [14, 16]. Technologies used in virtual reality simulation allow educators to create immersive environments where students can practice procedures and interact with virtual patients, free from the limitations of time and location [17]. By replicating complex patient care environments, these virtual simulations allow students and professionals from various disciplines such as medicine, nursing, and allied health to practice and refine their skills in a risk-free setting [10, 18].

Despite the growing recognition of the importance of IPE in preparing health sciences students for collaborative practice, its implementation remains constrained by fragmented curricula, discipline-specific teaching, and persistent logistical challenges. Traditional face-to-face IPE approaches are often limited by geographical dispersion, scheduling conflicts, variable clinical placements, and resource intensity, resulting in inconsistent and inequitable learning opportunities. Recent advances in technologies that enable virtual simulation introduced new possibilities for addressing these challenges. Evidence suggests that virtual simulation can provide flexible, scalable, and immersive learning environments that replicate authentic clinical scenarios, facilitate synchronous and asynchronous participation across locations, and support standardised experiences. These developments suggest virtual simulation as a possible pedagogical solution for enabling access to shared training environments and fostering teamwork, communication, and role clarity across disciplines.

However, existing research on virtual simulation in IPE has predominantly focused on feasibility, technological capability, and measurable competency outcomes, with limited attention to students’ lived experiences of this teaching approach. There remains a gap in understanding how students perceive virtual simulation as a teaching and learning method. Therefore, the purpose of this study was to explore students’ experiences of virtual simulation as a strategy to overcome siloed teaching and support the development of core interprofessional competencies within health sciences education.

Methods

Design

A qualitative, descriptive, exploratory, and contextual research design was employed to gain an in‑depth understanding of students’ experiences and perspectives on virtual simulation as a strategic approach to reducing siloed teaching and supporting the development of shared interprofessional competencies within health sciences education.

Study population

The study population consisted of 29 students purposively sampled from five health science disciplines: Emergency Medical Care (EMC), Nursing, Podiatry, Chiropractic, and Medical Imaging and Radiation Sciences (MIRS). Eligibility for inclusion required active participation in virtual simulation-based IPE activities.

Sampling

Purposive sampling was used to recruit senior‑level health sciences students who had direct experience with virtual simulation‑based IPE during their clinical education. Participants were selected from disciplines where virtual simulations were actively integrated into clinical training. Selected participants included students who had previous exposure to virtual simulation IPE activities.

Setting

This study was conducted within the Faculty of Health Sciences (FHS) at the University of Johannesburg (UJ), a comprehensive higher education institution located in the Gauteng Province of South Africa. The FHS at UJ comprises 11 academic departments, namely EMC, Nursing, MIRS, Podiatry, Complementary Medicine, Sport and Movement Science, Biomedical Sciences, Chiropractic, Environmental Health, Human Anatomy and Physiology, and Optometry. The Faculty offers a wide range of undergraduate and postgraduate programmes across these health science disciplines. Several departments within the FHS, including Emergency Medical Care, Nursing, Podiatry, Medical Imaging and Radiation Sciences, Complementary Medicine, and Chiropractic, actively integrate simulation‑based learning as a pedagogical approach within their curricula. These simulation activities are used to support the development of clinical, technical, and interprofessional competencies within authentic learning environments.

Data collection

Data collection took place between January and June 2024 following approval from the Faculty of Health Sciences Research Ethics Committee (REC-2455-2023) and the Higher Degrees Committee (HDC-01-100-2023). Institutional gatekeeper permission was obtained prior to commencement of the study. To address anticipated scheduling constraints and optimise participant accessibility, semi-structured focus group interviews were conducted online using Microsoft Teams. Four focus groups were convened, each comprising between five and eight students drawn from different academic levels and departments. Sessions were scheduled in the evening (19:00–20:30) to maximise participation and lasted approximately 60–90 min. All interviews were facilitated by an experienced external qualitative researcher who was independent of both the research team and the institution under study, ensuring neutrality and promoting open, in-depth discussion.

The focus group interviews were guided by a central research question developed specifically for this study (See attached supplementary file: Interview guide). The central question was: “What are your views regarding the use of technology in interprofessional simulation in your curriculum?” with additional probing questions such as: “In what ways did virtual simulation then affect your understanding of your own professional role within the interprofessional team?”, “Did you feel all team members had equal opportunities to contribute during the simulation?” and “What aspects of virtual simulation would you say influenced your confidence or learning?”. Probing questions were guided by participants responses and aligned with the study objectives. The facilitator employed established qualitative interviewing techniques, including active listening, clarification, paraphrasing, reflection, and summarisation, to encourage rich dialogue and sustain participant engagement throughout each session.

The virtual simulation platform in this study included features such as session recording, structured debriefing playback, and facilitator-guided feedback. While some participants referred to ‘AI-supported’ elements, these were primarily experienced as system-generated prompts and feedback summaries rather than fully autonomous AI systems. The study did not formally evaluate AI algorithms or adaptive learning engines.

Trustworthiness

To ensure the trustworthiness of the study, the Lincoln and Guba’s framework was adhered to, which encompasses credibility, transferability, dependability, and confirmability [19]. Credibility was established through several strategies: prolonged engagement with the data, methodological triangulation, peer debriefing, and the maintenance of a reflective journal. Transferability was supported by a purposive sampling strategy and the provision of thick, descriptive data regarding the research context and participant demographics, enabling readers to assess the findings’ relevance to other settings. Dependability was achieved through a stepwise replication process and an inquiry audit, alongside comprehensive documentation of the entire research process, including coding procedures that were reviewed by an independent coder. Finally, confirmability was secured by maintaining a detailed audit trail, employing triangulation, and using reflexive journaling to bracket researcher bias, thereby ensuring that the findings were rooted in the participants’ authentic perspectives, which were represented through verbatim quotations.

Data analysis

Data analysis was guided by the Matrix Building Framework which facilitates systematic thematic development through iterative coding and categorisation [20]. The process unfolded in three sequential phases:

• Initial Coding: Verbatim transcripts from each focus group underwent line-by-line analysis. Codes were generated inductively to capture emergent patterns and salient concepts related to communication and collaboration.

• Theme Development: The initial codes were clustered into conceptually similar categories. These categories were then abstracted and synthesised into overarching themes and sub-themes that represented the core of the participants’ experiences.

• Verification and Consensus: To ensure analytical reliability, an independent coder reviewed a subset of transcripts and the proposed coding framework. Any discrepancies in coding or thematic structure were discussed until a consensus was reached.

Results

As depicted in Table 1, the study comprised 29 participants comprising 58.6% (n = 17) females and 41.4% (n = 12) males who were divided across four separate online focus groups hosted on Microsoft Teams.

Table 1.

Demographic infomration (Authors’ own work)

Gender		Department					Total
Male	Female	EMC	Nursing	MIRS	Chiropractic	Podiatry
41.4%	58.6%	27.6%	31.0%	20.7%	13.8%	6.9%	100%

Data analysis revealed that virtual simulation not only strengthens interprofessional competencies by reducing geographical and scheduling barriers but also serves as an enabler of accessible, equitable, and authentic collaboration. Furthermore, it provides a supportive and individualised pathway to professional confidence, with two overarching themes and four subthemes highlighting the development of collaborative practice (Table 2).

Table 2.

Themes and subthemes (Authors’ own work)

Themes	Subthemes
Virtual simulation as an enabler of accessible, equitable, and authentic interprofessional collaboration	Real-time collaborative communication in high-fidelity virtual contexts
	Enhanced learning through flexible access and scheduling efficiency
	Equitable and standardised interprofessional learning experiences
Virtual simulation as a supportive and individualised pathway to professional confidence	Personalised simulation supporting professional confidence and role development
	Equitable, low pressure learning environments that enable learner autonomy and confidence

Theme 1:Virtual simulation as an enabler of accessible, equitable, and authentic interprofessional collaboration

This theme summarises participants’ experiences of virtual simulation as a platform for IPE. The results indicate that participants experienced virtual simulation as expanding access, promoting equity, and facilitating authentic collaborative practice. Participants described how virtual simulation reduced traditional logistical and structural barriers such as geographical location, scheduling constraints, and placement variability thereby enabling meaningful engagement in interprofessional learning across disciplines and sites. Beyond improving access, students perceived high-fidelity virtual simulation to support real-time, interactive communication and shared decision-making, mirroring the dynamics of real-world clinical teamwork. These experiences suggest that virtual simulation may be a plausible substitute for in-person activities.

Subtheme 1.1: Real-time collaborative communication in high-fidelity virtual contexts

Participants described virtual simulations as creating dynamic clinical environments that required ongoing, real-time communication and shared decision-making across disciplines. Participants perceived virtual simulation environment as transformative, noting that its immersive and consequence-based nature of ensured deeper understanding of collaborative practice than traditional classroom learning:

“The manikin vital signs in the scenario kept deteriorating, and our ‘team’ had to quickly debate the next steps. Making a wrong choice in that simulation and seeing the consequences in real-time, without harming anyone, was a powerful lesson in speaking up and collaborating under pressure that you just don’t get from a textbook” P4, FG3.

“Being able to log in from my res and do a simulated handover with another nursing student who was miles away was incredible. It forced us to be crystal clear in our communication without the non-verbal cues we usually rely on, which is a skill I’ve already used on my ward rotations" P2, FG2.

Another participant reflected the impact of one virtual simulation IPE session between Nursing and MIRS students. The participant reflected that the virtual environment created collaborative problem-solving between the disciplines to address complex patient needs:

“During the simulation, the ‘patient’s’ condition changed based on our combined actions. It forced our nursing team to constantly update radiology students and vice-versa. That back-and-forth wasn’t just about handing over information; it was a lightbulb moment for understanding how our decisions directly impact each other’s work and the patient’s outcome”P3 FG1.

These results indicate that virtual simulation enabled authentic, real-time collaboration in IPE by recreating the complexity, urgency, and interdependence of real-world clinical practice. Through dynamic patient scenarios and immersive digital environments, participants had to communicate clearly, make shared decisions, and recognise the reciprocal impact of their actions on team members across disciplines. These findings suggest that virtual simulation developed participants’ collaborative competencies in ways that transcended traditional classroom learning. This affirms virtual simulation as an alternative and accessible medium for cultivating for developing interprofessional teamwork.

Subtheme 1.2: Enhanced learning through flexible access and scheduling efficiency

Participants described virtual simulation as enabling scheduling flexibility, allowing them to engage in IPE without the logistical constraints associated with in-person sessions. Participants perceived that the ability to participate remotely from clinical or home environments increased access to critical team-based practice opportunities that might otherwise have been missed. Participants said:

“The efficiency of the virtual system meant we spent less time on logistics and more on learning. Having the session automatically recorded and readily available for debriefing allowed us to immediately replay and discuss our team’s communication gaps, which made the feedback incredibly powerful and direct”P2, FG3.

“The virtual platform is a game-changer; I can now fit these crucial team practices into my schedule from my clinical site or home, which means I actually get the interprofessional experience I need”P1, FG2.

These results indicate that participants believed that virtual simulation efficiencies transformed IPE from a procedurally constrained activity into an accessible, feedback-rich environment that fostered the development of applied collaborative competencies. They noted that this shift enabled immediate replay and critical analysis of team interactions, supporting deeper reflection on communication practices and collaborative decision-making.

Subtheme 1.3: Equitable and standardised interprofessional learning experiences

Participants reported that virtual simulation promoted equity and standardisation in IPE by ensuring all students engaged with the same core clinical scenarios, regardless of their clinical placement or geographic location. This consistency was perceived as addressing long-standing disparities in simulation exposure and strengthening shared foundational competencies across disciplines:

“Before this virtual program, your IPE experience totally depended on which clinical site you were placed at. Now, whether you’re at the main campus or a regional centre, every student goes through the same core scenarios. It finally feels like we’re all getting the same foundational training” P1, FG2.

“The system’s ability to record and play back our team’s communication word for word, took the subjectivity out of debriefing. We weren’t just relying on one instructor’s memory; we had concrete, standardised evidence of where our handover succeeded or failed, which was incredibly powerful for our learning” P1, FG4.

Participants interpreted system prompts within the platform as ‘AI-supported’ facilitation, although these reflected structured prompting features rather than independently adaptive AI systems:

“As a student who often felt sidelined in fast-paced, in-person simulations, the structured format of the virtual platform was a game-changer. The AI facilitator prompted me specifically for input, ensuring I had the same chance to practice advocating for the patient as everyone else” P6, FG2.

These results indicate that virtual simulation standardises IPE and ensures that all students regardless of discipline or campus location, develop a shared foundation of collaborative competencies. With the use of uniform simulation scenarios and consistent assessment criteria, the results further indicate that virtual simulation mitigates longstanding variability in training quality and access.

Theme 2: Virtual simulation as a supportive and individualised pathway to professional confidence

This theme reflects participants’ experiences of virtual simulation as an educational approach that supports the development of professional confidence through personalised learning and psychologically safe practice environments. Participants described how virtual simulation with adaptive design, intentional role allocation, and individualised feedback enabled them to address personal learning needs, practise professional roles, and develop their voice within interprofessional teams. Furthermore, participants perceived virtual simulation as reducing performance anxiety and structural inequities, allowing them to engage more autonomously and authentically with clinical decision-making. These experiences indicate that virtual simulation can help develop confidence, role clarity, and professional identity for students within IPE.

Subtheme 2.1: Personalised simulation supporting professional confidence and role development

Participants described how virtual simulations, and personalised and individualised feedback supported the development of confidence and professional role identification. Participants further reflected that targeted role assignments enabled them to address self-identified weaknesses in leadership and decision-making. In parallel, personalised feedback mechanisms provided a safe space for them to reflect on hesitations such as reluctance to speak up and to develop strategies for patient advocacy within interprofessional teams.

“The simulation didn’t just throw a standard case at me. After I correctly managed the initial airway, the patient’s condition deteriorated into a complex sepsis scenario, which felt like the system was challenging me specifically based on my skill level. It pushed me right to the edge of my competence without being overwhelming” P6, FG3.

“The virtual simulation I was assigned specifically placed me as the team lead in a chaotic emergency room scenario, it was clearly built to target that exact weakness I identified” P7, FG2.

“During the IPE simulation, I noticed the patient’s respiratory rate was increasing, but the other members of the team were focused on something else. I was hesitant to speak up. In the personalised feedback report, I mentioned my fears” P1, FG4.

Participants’ accounts illustrate how virtual simulation functioned as a targeted and personalised developmental tool rather than a generic training experience. The adaptive design of the virtual simulation dynamically increased scenario complexity, deliberately challenging their clinical judgement while aligning tasks with their self-identified areas for growth.

Purposeful role allocation created opportunities for the participants to practise leadership and decision-making in a safe environment. The technology used in virtual simulation allowed participants to notice their own nuanced non-technical behaviours such as hesitation to speak up. Participants reflected that that this capability of virtual simulation enabled them to recognise and reflect on their communication barriers without fear of real-world consequences. The results indicate that virtual simulation supports the development of confidence, professional voice, and interprofessional role identification.

Subtheme 2.2: Equitable, low-pressure learning environments that enable learner autonomy and confidence

Virtual simulation was perceived as a tool for creating an equitable and psychologically safe learning environment that supported their autonomy and the development of confidence. Participants perceived that remote access to high-fidelity simulations reduced both financial and logistical burdens associated with campus-based simulation sessions. Several participants noted that the reduced performative pressure of virtual environments alleviated anxiety, allowed them to demonstrate their own competence, and felt empowered to engage fully and confidently in interprofessional practice. Participants said:

“Being able to access a high-fidelity virtual simulation from my laptop at home was a game-changer; I couldn’t afford the extra travel and time to get to the campus simulation lab for extra practice, and this put me on an equal footing with my peers” P4, FG4.

“The virtual simulation platform meant I could complete the scenario independently for the first time, without needing a dedicated note-taker” P6, FG3.

“Virtual simulation enabled me to focus on the clinical decision-making without the unnecessary anxiety of everyone physically staring at me. I could finally demonstrate what I knew” P4, FG4.

These results suggest that virtual simulation allows equitable, low‑pressure learning environments that enable learners to engage autonomously and build professional confidence. By eliminating challenges such as finances related to transportation, logistical arrangement for simulation, and social barriers, virtual simulation allowed students to focus on clinical reasoning and authentic skill demonstration. This means that students participate in IPE on equal footing with their peers and they can practise interprofessional competencies. Therefore, virtual simulation can be used as a critical enabler of inclusive, confidence‑building pedagogical tool within IPE.

Discussion

Participants in this study perceived virtual simulation as helping to mitigate longstanding structural barriers in IPE, such as geographical dispersion, scheduling challenges, and inconsistent clinical placements, while maintaining a sense of authentic, real-time collaboration. Participants reported that high-fidelity virtual simulation replicated the dynamics of clinical teamwork, especially when patient states evolved in response to team actions, requiring clear communication, shared decision-making, and continuous role interdependence. These experiences suggest that virtual simulation can be used to standardise collaborative opportunities across health science programmes and campuses, expanding access without diluting fidelity [21]. These results align with the WHO’s definition of IPE, which emphasise that it is about, from, and with other professions to enable effective collaboration [1], while also meeting IPE Collaborative (IPEC) competency domains of roles and responsibilities, communication, and teamwork [22, 23]. Thus, virtual simulation is well-suited to create shared learning experiences mapped to these competencies, regardless of physical location [22].

Participants’ experiences of dynamic, consequence-based scenarios during virtual simulation indicate that virtual simulation may be used to develop and enhance team communication under pressure. Research on virtual simulations for IPE report on improvements in non-technical skills such as collaboration and communication and described virtual simulation as being able to orchestrate team decision-making in evolving clinical conditions such as in emergency and critical care. Furthermore, research using TeamSTEPPS framework further strengthen the importance of virtual simulation for training and assessing teamwork, indicating growing measurement validity and educational impact [1, 15, 24].

Participants described scenarios in which patient conditions changed in response to team actions, giving the impression of responsive or adaptive simulation environments. While this study did not directly evaluate algorithm-driven systems, such features are described in the literature as supporting interdependent team behaviours. Dynamic and responsive virtual simulation environments mirror real‑world clinical complexity and enhance collaborative decision‑making by reinforcing the reciprocal impact of each profession’s actions on patient outcomes [15]. To ensure that such learning translates into measurable competency development, research suggest that teamwork must be deliberately assessed using validated instruments adapted for virtual simulation contexts, including TeamSTEPPS‑based tools like the Team Performance Observation Tool (TPOT) and teamwork perception questionnaires [15]. These assessments should be embedded within evidence‑based debriefing processes that focus explicitly on observable communication behaviours, role clarity, leadership, and mutual performance impact, enabling structured reflection and reinforcing key interprofessional competencies within virtual simulation-based IPE [15].

Participants further reflected on the value of remote access and related capabilities of virtual simulation which allow more time for learning. During the COVID-19 pandemic, many education and training programmes quickly shifted to distance and hybrid simulation. What emerged from this period was not just a temporary workaround, but a strong indication that these approaches are both practical and desirable beyond crisis conditions [13]. Evidence from remote and rural simulation initiatives also highlights an important lesson: success is not only about the technology itself, but about fostering meaningful connections among participants. Building a sense of community across geographically dispersed groups is essential for long-term sustainability and inclusion [25]. When used thoughtfully, virtual platforms can play a powerful role in creating and maintaining these communities of practice, helping learners feel engaged, supported, and connected despite physical distance. Students and educators reported a clear intention to continue using them because of their flexibility and effectiveness [13].

To maximise participation and learning in virtual simulation for IPE, higher education institutions may consider implementing centralised scheduling hubs that support coordinated timetabling and on-demand access to simulation activities, including evening or off-shift offerings that accommodate students’ clinical placement responsibilities. Centralised and flexible scheduling structures have been shown to reduce logistical barriers and enable more consistent engagement across geographically dispersed and clinically active cohorts [25]. In addition to improving access, virtual simulation and related technology can enable data-informed debriefing practices by leveraging session recordings and system-generated analytics. Using recorded interactions during IPE sessions in virtual simulations, facilitators and learners can focus debriefings on observable and verifiable team behaviours such as handover quality, communication clarity, and coordination rather than relying solely on participant recall, which can be subjective and incomplete [25].

Participants in this study also perceived standardised scenarios and assessment criteria across clinical placements as valuable. They reflected that this consistency reduced variability in learning experiences and promoted greater equity within IPE. Participants perceived that engaging with the same core scenarios, regardless of location or placement context, ensured the development of collaborative competencies. This finding is supported by evidence demonstrating that virtual simulation for IPE can yield learning outcomes comparable to those of in-person simulation, while simultaneously enabling greater consistency in competency development across cohorts [14]. When curricula are intentionally aligned with established frameworks such as the IPEC core competency domains, virtual simulation standardised exposure to key interprofessional skills including communication, role clarification, and teamwork [22]. However, the literature also cautions that standardisation should be implemented alongside contextual flexibility, allowing scenarios to be adapted to local practice environments and learner needs to preserve authenticity and relevance.

From an implementation perspective, these findings suggest that institutions may benefit from considering the use of shared interprofessional scenario sets housed within digital repositories, with each scenario explicitly mapped to IPEC competency domains and assessed using consistent rubrics to ensure fairness and transparency across disciplines and sites [22]. Such alignment would support both curriculum coherence and equitable assessment practices. In addition, equity must be intentionally embedded in simulation design and delivery through ongoing audits of student participation, performance data, and access to technological resources. Evaluating factors such as device availability, internet connectivity, and protected learning time allows institutions to identify and address structural barriers that may disadvantage certain learner groups [25]. These strategies can support a standardised and inclusive approach to virtual simulation for IPE that balances consistency with responsiveness to diverse educational contexts.

The second theme from the results highlights how virtual simulation supports individual learner development by fostering professional confidence, leadership practice, voice development, and patient advocacy within psychologically safe learning environments. Participants described how personalised elements including intentional role allocation such as assignment to team leader roles, adaptive escalation of scenario complexity, and individualised performance feedback functioned together to create a developmental feedback loop in which simulation challenges were informed by learner performance. These findings align with emerging evidence on technology-enhanced virtual simulations for interprofessional communication, which demonstrates that intelligent virtual agents can expand opportunities for repeated, scaffolded practice, particularly in contexts where access to human interprofessional partners may be limited [7]. Moreover, literature examining personalised feedback in digital learning environments consistently reports positive effects on learner engagement, self-efficacy, and skill acquisition, particularly when feedback is timely, specific, and aligned with individual performance data [26]. These findings suggest that virtual simulation offers a learner-centred pathway for professional growth by integrating adaptive challenge and personalised feedback within low-risk, psychologically supportive IPE contexts.

Participants’ accounts of adaptive difficulty and purposeful leadership roles are consistent with a growing body of evidence demonstrating that virtual simulations can individualise learning through features such as branching scenario complexity and dynamically assigned role prompts. Literature indicates that these approaches support improvements in communication performance and self-efficacy that are comparable to outcomes achieved through human-facilitated team practice, while offering greater scalability and flexibility. By enabling repeated deliberate practice and real-time adjustment to learner performance, virtual simulations can create structured opportunities for students to exercise leadership, advocacy, and decision-making skills within psychologically safe environments [27, 28].

Personalised feedback, particularly when grounded in observable behaviours and delivered in close temporal proximity to performance, has been shown to be one of the most powerful influences on learning in higher education. Literature consistently report that behaviour-anchored feedback enhances learners’ sense of competence, autonomy, and reflective insight [29, 30]. In virtual simulation, personalised feedback can be strategically used to reinforce core interprofessional competencies and identify missed opportunities for development, thereby supporting targeted skill development across health science professions.

Additionally, participants highlighted that remote access, the capacity to complete scenarios independently, and reduced performative anxiety enabled more authentic demonstration of skills. These findings align with evidence highlighting the central role of psychological safety in simulation and IPE. Common threats to psychological safety were identified from the literature, including hierarchical dynamics and observation-related stress, and emphasise the importance of well-structured pre-briefing and skilled facilitation to balance challenge with support [31, 32]. When learners perceive simulation environments as safe, they are more willing to “risk failure,” practise voice behaviours, and engage in reflective learning without fear of real-world consequences, thereby fostering confidence, autonomy, and professional identity formation.

Implications arising from these findings include the intentional use of adaptive challenge mechanisms and individual feedback reporting. Future implementations may consider incorporating branching logic to scale scenario complexity in response to learner performance, while rotating participants through leadership and advocacy roles ensures systematic exposure to identified growth areas [27]. In addition, succinct, individualised feedback reports that are explicitly linked to observed behaviours can support deliberate practice by setting clear micro-goals for subsequent simulation experiences, strengthening self-regulated learning processes [29, 33].

To further support these outcomes, simulation design may incorporate explicit safety scaffolds, including consistent pre-briefing practices that set expectations for fallibility, respectful communication, and shared responsibility for learning. Debriefing models should be used normalise error as meaningful data for improvement rather than personal deficiency, reinforcing a growth-oriented learning culture [31]. Furthermore, inclusive access strategies such as loaner devices, bandwidth support, and asynchronous participation options may be important considerations to prevent digital inequities that could undermine the accessibility and equity advantages of virtual simulation [34].

Limitations

The findings from this study should be interpreted in light of several limitations. Firstly, this study was conducted at a single higher education institution within a specific Faculty of Health Sciences, which may limit the transferability of the findings to other institutional, curricular, or healthcare education contexts. Participants were drawn from specific health science disciplines and had prior exposure to TEIPS; therefore, their experiences may not reflect those of students in institutions with different resource profiles, levels of technological integration, or approaches to interprofessional education. Additionally, the qualitative design and reliance on self-reported perceptions focus on students’ subjective experiences rather than objective measures of learning or clinical performance might restrict the extent to which findings can be generalised beyond the study context. Furthermore, this study did not objectively measure learning outcomes or directly evaluate technological features such as AI functionality, therefore, the authors were not able to draw conclusions about system performance.

Conclusion

This study contributes to the simulation and IPE literature by highlighting students’ perceptions of virtual simulation as both a system level and learner level support for IPE. It adds qualitative depth to the evidence base and highlights how virtual simulation is perceived not as a mere substitute for face-to-face IPE, but as a pedagogical modality that could be used to shape access, experience, and enactment of interprofessional learning. Additionally, the findings indicated the value of aligning virtual infrastructure, pedagogical design, and evaluation to support sustainable IPE. Therefore, by documenting how students interpret these features in relation to equity, authenticity, and confidence, this study helps clarify the conditions under which virtual simulation may contribute to IPE. In doing so, this study informs ongoing efforts to move virtual simulation beyond innovation toward normalised, evidence-informed practice within health sciences education.

Authors’ contributions

MM was the principal researcher and drafted the manuscript. RR, SM, LM critically reviewed the manuscript and made conceptual contributions.

Funding

The authors received no financial support for the research and authorship of this article.

Data availability

The data analysed in this study are accessible upon reasonable request from the corresponding author.

Declarations

Ethics approval and consent to participate

This study was carried out in conformance with the principles outlined in the Declaration of Helsinki. Ethical clearance for the study was obtained from the University of Johannesburg’s Faculty of Health Sciences Research Ethics Committee and the Higher Degrees Committee (REC-2455-2023). Permission to access participants was granted by the institutional gatekeeper and relevant departmental heads. Informed consent was secured from all participants, who were briefed on their rights, including voluntary participation and the option to withdraw without penalty. Privacy and confidentiality were strictly maintained through anonymised coding and secure data storage. Confidentiality agreements were signed by the independent coder and external interviewer.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.