Does training setting matter? Nontechnical skills performance in interprofessional emergency teams during in situ and simulation center–based simulation

Background Nontechnical skills are essential for safe and effective performance in emergency care. Simulation-based training is widely used to develop these competencies; however, the extent to which training setting influences team performance remains uncertain. This study examined whether in situ simulation and simulation center–based simulation were associated with differences in observed nontechnical skills performance among interprofessional emergency teams in a Brazilian healthcare setting. Methods This quantitative cross-sectional study included interprofessional healthcare professionals participating in emergency simulation training. Team performance was assessed via the Brazilian Portuguese version of the Team Emergency Assessment Measure (bp-TEAM). Sixteen teams (8 in situ and 8 simulation center-based) were video recorded and independently evaluated by seven expert raters. The participants completed a questionnaire assessing their perceptions of nontechnical skills learning and its applicability to professional practice. The content validity of the questionnaire was established through expert review. Results Sixteen interprofessional teams comprising 71 participants generated 112 independent bp-TEAM assessments. Interrater reliability was good (ICC = 0.798; 95% CI 0.590–0.919). No statistically significant differences were observed between in situ and simulation center–based training for global ratings (7.73 vs. 7.32; p = 0.5251) or total bp-TEAM scores (33.7 vs. 30.38; p = 0.3062). Among 48 questionnaire respondents, most reported a high likelihood of applying learning related to leadership, communication, teamwork, and task management in professional practice, and 97.9% indicated that such training should occur more frequently. The questionnaire demonstrated excellent content validity (agreement coefficient = 0.963). Conclusions No statistically significant differences in nontechnical skills performance were observed between simulation settings. These findings suggest that factors such as participant experience, team composition, and institutional simulation culture may have a greater influence on team performance than the physical training environment. Both settings were associated with positive perceptions regarding the applicability of nontechnical skills to clinical practice.