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International Journal of Medical Education. 2021;12:267-273 ISSN: 2042-6372 DOI: 10.5116/ijme.61b3.214c International trainer perceptions of simulation-based learning: a qualitative study Junichi Fukamizu¹, Daniëlle Verstegen², Sin Chi Ho³ 'Terumo Corporation, Tokyo, Japan ²School of Health Professions Education/Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht Netherlands, the Netherland *Terumo Asia Holdings, Singapore Correspondence: Junichi Fukamizu, Tokyo Opera City Tower 49F, 3-20-2, Nishi-Shinjuku-ku, Tokyo, 163-1450, Japan Email: [email protected] Accepted: December 10, 2021 Abstract Objectives: This study examined trainer perceptions of sim- ulation-based learning for Contining Professional Develop- ment in international settings. Methods: A qualitative research methodology was used to gain insight into trainer perceptions. Seventeen international physician trainers involved in simulation training in cardio- vascular catheterization and intervention were interviewed. An inductive thematic analysis was performed following steps described by Braun and Clarke, researchers inductively approached, and then carefully dissected the transcripts into individual storic grounded the problems, and explored themes. Results: Trainer perceptions are largely aligned with learning theories, even though they were not specifically educated in simulation-based learning and program design principles in advance. Trainers perceive their primary role as facilitators to be most important and consider structuring sessions, fa- cilitating group learning, and stimulating reflection to be crucial themes in simulation-based learning. They believe Introduction Simulation-based learning (SBL) has an important role in that building trust is an underlying principle to function in their role and feel responsible for being prepared to improve trainee satisfaction as adult learners. Trainers believe that learning from making mistakes is an important mechanism in simulation-based learning, but they give less attention to giving feedback. Conclusions: Trainers with basic training in facilitation skills in a classroom may unconsciously follow teacher-stu- dent instructional models with which they are familiar. This study confirms that trainers in simulation-based learning need pedagogical and facilitating skills to guide trainees and facilitate group processes. Educational training for trainers should include building trust and giving feedback in a more explicit place. In future studies, a mixed-method methodol- ogy is suggested to evaluate multi-layered complexities of ed- ucational practices. Keywords: Simulation, facilitation, trust, feedback, continu- ing professional development acquisition of complex skills.2 For example, cardiovascular