Table 2 Results of content analysis, organized by themes (in bold), with subthemes, categories and supporting quotes

Identity formation. ‘Necessity is the mother of invention’

Being conscious of the two roles: as a professional and a private person

The role of the physician

‘Yes, a little, because you become like that again—now she is very upset and then, the problematic dilemma is how much I should comfort because I still want her trust, well you want to build trust but it should not be too much outside the doctors' role’ (S)

‘You become in a way very curious as a person and you want to cave down a bit in the yummy bits though it is maybe not the right way to behave as a professional’ (S)

Being surprised in a safe atmosphere makes the students lower the guard and be more present

Manage emotional responses

‘Just as I said, you can observe your own responses to unexpected events in the consultation’ (S)

The simulation was positive for learning

Exposed to strong emotions

‘Yes, it is probably some sort of reaction of fear. A little bit, anyway. Thus, learning …’ (S)

A certain amount of uncertainty creates learning

Insecurity supports learning

‘Balanced stress, balanced surprise, but being safe in that you can get help when you need it. I think that is a rather optimal learning curve if you consider how we live our life, yes but also if we consider how children learn and all other things, you should have the right amount and there has to be someone to consult if it breaks down’ (T)

Collaborative learning. ‘It takes two to tango’

It was easy to be on two levels simultaneously, one fictive and one real

Easy to put oneself in a situation

‘You sign a contract -Now we are going to roleplay’ (S)

It takes two to tango

Actions of the SP

‘And as a patient now […..] that perspective it is nothing you… what can I say… regulate, you are on some sort of meta level but the basis, the emotions and the relation you cannot adjust, well you can but what happens is based on genuine responses, experienced responses of how you were treated’ (SP)

A detailed structure supports the opportunity for learning

The interactive design of the simulation

‘Well, it becomes more or less varied, and it depends on their [students’] responses and how they grasp things’ (SP)

Learning intentions. ‘A path on the map shows the way forward’

To be pushed to discard one’s planned communication but keep the communicative strategies was a learning experience

Planned communication

‘I think many of the students have a long list in mind on what they have to ask. That is what we as teachers also have talked much about. You have to do a suicidal risk assessment; you have to ask if they have children…. well, there are some mandatory questions’ (T)