Tag team simulation: An innovative approach for promoting active engagement of participants and observers during group simulations

• Simulation observers can lose interest and disengage from the learning experience.
• Tag Team Simulation ensures that both participants and observers have equally active and integral roles in simulation.
• A Tag Team pain simulation implemented with second year nursing students revealed no significant difference in satisfaction scores.

Active participation in immersive simulation experiences can result in technical and non-technical skill enhancement. However, when simulations are conducted in large groups, maintaining the interest of observers so that they do not disengage from the learning experience can be challenging.We implemented Tag Team Simulation with the aim of ensuring that both participants and observers had active and integral roles in the simulation. In this paper we outline the features of this innovative approach and provide an example of its application to a pain simulation.Evaluation was conducted using the Satisfaction with Simulation Experience Scale. A total of 444 year nursing students participated from a population of 536 (response rate 83%). Cronbach's alpha for the Scale was .94 indicating high internal consistency. The mean satisfaction score for participants was 4.63 compared to 4.56 for observers. An independent sample t test revealed no significant difference between these scores (t (300) = −1.414, p = 0.16).Tag team simulation is an effective approach for ensuring observers' and participants’ active involvement during group-based simulations and one that is highly regarded by students. It has the potential for broad applicability across a range of leaning domains both within and beyond nursing.