This study examines the contribution of Simulation-Based Learning (SBL) to the professional development and role perception of teachers working in hospital settings. Hospital teachers face unique challenges in their educational practice, including constantly changing student populations, medical constraints, and the need to balance educational goals with healthcare priorities (Stienka et al., 2016). Through a qualitative research approach involving 25 teachers from four hospital departments (emergency, surgery, pediatrics, and oncology), this study investigated how simulation workshops impact teachers' professional development. Data was collected through questionnaires and in-depth interviews with participants who attended three simulation workshops over five months. The findings revealed five central themes: role complexity in the medical-educational space, the significance of simulations for professional learning, challenges in simulation participation, the duality of the learning process, and recommendations for program enhancement. Results indicate that SBL provides an effective framework for developing essential professional skills and personal-emotional competencies, particularly in areas of communication, decision-making, and emotional resilience. The study highlights the importance of creating structured, ongoing simulation programs to support hospital teachers' professional growth and recommends the integration of SBL into systematic professional development frameworks.

Unlike traditional school environments, where teaching follows a structured curriculum and student attendance is stable, hospital teaching involves multiple layers of challenges, including environmental constraints (such as limited physical space and fluctuating student numbers), professional demands (such as coordinating with medical teams and maintaining continuity with students' home schools), emotional stress (resulting from exposure to student suffering and grief (McNamara, 2022), and systemic barriers (such as limited professional development opportunities and professional isolation, (Hen & Gilan-Shochat, 2022; Benigno & Fante, 2020). The professional challenges are multifaceted, as the role of the hospital teacher includes various tasks: mediating medical procedures, providing individual instruction, offering emotional support to students and their families, managing multiple stakeholder relationships, and maintaining professional boundaries (McCarthy et al., 2017). This requires teachers to have high intuition, flexibility, and creativity (Hen & Gilan-Shochat, 2022).

Simulation-Based Learning has emerged as a key pedagogical approach for professional development, particularly in complex and unpredictable work environments. It offers educators an opportunity to engage in experiential learning through realistic scenarios, allowing them to refine their responses to challenging situations within a safe and controlled setting. The literature highlights SBL as a method that fosters the development of essential skills such as advanced communication with medical personnel and families, problem-solving in unpredictable circumstances, and emotional resilience in high-stress environments. By engaging in these experiences, educators develop deeper self-awareness, improve their decision-making abilities (Levin, 2021; Morris, 2019), and enhance their capacity for empathy and resilience (Chernikova et al., 2020). Research suggests that simulation training leads to long-term benefits, including greater job satisfaction, stronger collaboration skills, and an improved ability to navigate the complexities of hospital education.

This study contributes to the growing body of research on teacher education in specialized settings, offering insights into how SBL can be leveraged to support and empower educators in hospital schools (Barshaf & Shinhar, 2023). By examining the lived experiences of teachers and the impact of simulation-based training on their professional development, this research aims to inform future training programs and policies designed to enhance the effectiveness and well-being of educators working in medical environments.

The research method was qualitative and included 25 teachers working in four departments at a children's hospital in central Israel: emergency, surgery, pediatrics, and oncology. The participants were divided into two groups, and each group participated in three simulation workshops held over a period of five months. The workshops, conducted at the hospital with professional actors, included scenarios adapted to the professional needs of the teachers. For data collection, all participants completed questionnaires, and ten of them participated in semi-structured in-depth interviews. The questionnaires and interviews were analyzed using a qualitative method that included identifying central themes, categories, and subcategories. Findings The analysis of findings revealed five central themes reflecting the complexity of the role, importance of simulations, challenges, learning process, and recommendations for continuation. The first theme emphasized the complexity of the role in the educational-medical space. It was found that teachers require great flexibility and constant personal adaptation, while creating quick and meaningful connections in short-term situations. They manage multidisciplinary work including collaboration with medical teams and information mediation, alongside dealing with parents under stress. Additionally, they must quickly identify emotional and physical needs and provide appropriate support. The second theme focused on the importance of simulations as a tool for professional learning. The simulations contributed to professional and personal improvement, emphasizing the development of communication skills and gaining an external perspective. A significant contribution was found to teamwork and understanding the roles of different participants. The safe environment allowed practice of challenging situations without real risk. The third theme identified challenges of participation in simulations, including emotional barriers such as fear of exposure and criticism. However, a positive conceptual change was observed during the process, with reduced resistance and increased involvement. The fourth theme reflected the learning process in simulations, which included immediate and effective learning alongside ongoing process learning. Improvement in performance was found following self-observation and feedback, and meaningful connection between simulation content and real situations. The fifth theme focused on recommendations for strengthening the simulation process and its continuity, including integration into organizational frameworks and expanding participation.

The unique complexity of the teacher's role in the educational-medical space emphasizes the need for advanced tools for professional development. Simulation-based learning (SBL) emerges as an appropriate response to this challenge, offering a safe framework for experiencing complex situations and multi-dimensional learning. The significant contribution of SBL is expressed in two main dimensions: improvement of professional skills and personal-emotional development. On the professional level, simulations enable teachers to refine their communication ability with students, parents, and medical teams, and develop essential skills in identifying emotional needs and decision-making in unexpected situations and uncertainty. On the personal-emotional level, the process deepens self-awareness and strengthens the sense of mission and meaning in their work. The learning process in simulations is characterized by duality: immediate learning occurring through self-observation and feedback, and process learning enabling assimilation and internalization over time. This combination increases the relevance of what is learned to daily reality in the hospital. However, the success of the process depends on several central factors: creating a safe environment that enables dealing with fears of exposure and criticism, more precise adaptation of scenarios to the unique needs of teachers, and deepening processing and reflection processes. In light of this, it is recommended to expand the scope of simulation use and even create a structured annual program that combines frequent meetings and ongoing monitoring. Integrating simulations into the professional development system may contribute significantly to empowering teachers and improving the quality of education in the medical space.

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