Simulation-based learning has become a prominent pedagogical approach in teacher education, particularly within clinical and practice-based models that emphasize experiential, reflective, and interaction-driven learning (Grossman et al., 2009). Clinical simulation relies on carefully designed scenarios enacted by professional actors and facilitated by trained educators, creating structured opportunities for novice and practicing teachers to engage with complex professional situations in a safe, reflective environment (Dotger & Chandler-Olcott, 2022).

Existing research in teacher education has largely focused on the micro-level of simulation practice, examining instructional design, facilitation strategies, emotional engagement, and reflective processes within the simulation workshop itself. While this body of work has substantially advanced understanding of pedagogical interaction in simulation, considerably less attention has been paid to the organizational and leadership conditions through which simulation quality is produced, stabilized, and sustained over time.

Drawing on perspectives from practice-based teacher education (Daniels & Varghese, 2020), professional learning (Darling-Hammond et al., 2017), and communities of practice (Patton & Parker, 2017), this study approaches simulation quality not solely as a function of individual pedagogical competence, but as an outcome constituted across interacting levels of professional practice and organizational organization. In this view, quality emerges through the alignment between micro-level professional interactions and macro-level infrastructures, including leadership practices, professional development pathways, shared professional language, and institutional norms. Thus, the study addresses the following research question: How is the quality of clinical simulation-based learning in teacher education constituted through the interplay between micro-level professional practices and macro-level organizational conditions?

To examine this question, the paper integrates findings from two complementary empirical phases conducted within a large-scale national simulation program in teacher education (blinded). Phase A focused on the micro-level of simulation practice and explored how facilitators and professional actors enact, negotiate, and reflect upon their roles during simulation workshops. Phase B extended the analytical lens to the macro-level, examining how simulation center directors conceptualize, develop, and support facilitator–actor collaboration within organizational, managerial, and policy frameworks.

By integrating these two perspectives, the study contributes to European and international debates on quality in teacher education, practice-based learning, and educational leadership. It positions clinical simulation as a professional practice whose effectiveness is shaped not only by pedagogical interaction, but by the organizational conditions under which such interaction is made possible and sustainable.

The study employs a qualitative case study design (Yin, 2018), examining clinical simulation in teacher education as a complex, multi-level phenomenon situated within its organizational context. The case is defined as a large-scale simulation program operating across multiple teacher education institutions, allowing for the exploration of shared patterns alongside contextual variation. Phase A involved 45 participants: 23 simulation facilitators and 22 professional actors working across 24 simulation centers. Data were collected using three qualitative data-collection tools: written reflections, semi-structured interviews, and a focus group. These tools were used to examine professional roles, interactional dynamics, emotional regulation, and judgment processes shaping learning within simulation workshops. Phase B included 19 simulation center directors representing diverse institutional and socio-cultural contexts. Data were likewise collected through written reflections, semi-structured interviews, and a focus group, focusing on organizational design, professional development processes, leadership practices, and policy mediation shaping facilitator–actor collaboration. Across both phases, data were analyzed using a thematic-cognitive approach, combining inductive thematic analysis with attention to participants’ meaning-making and professional reasoning. Triangulation across data sources, participant roles, and analytic phases enhanced the credibility and trustworthiness of the findings. The integrated design allows the study to move beyond isolated accounts of simulation practice toward a systemic understanding of how simulation quality is produced and maintained.

The findings indicate that the quality of clinical simulation-based learning in teacher education cannot be fully explained by pedagogical interaction alone. Phase A highlights the centrality of facilitator–actor coordination, authenticity management, emotional containment, and reflective mediation in shaping meaningful learning experiences during simulation workshops. However, Phase B demonstrates that these micro-level practices are deeply dependent on macro-level organizational conditions. Stable professional teams, structured training pathways, shared professional language, managerial mediation of tensions, and active communities of practice emerged as critical infrastructures enabling consistent simulation quality. Taken together, the findings suggest a shift from viewing the quality of clinical simulation as an outcome of localized pedagogical expertise toward understanding it as a relationally and organizationally constituted phenomenon. Simulation quality emerges through the ongoing alignment between professional interaction at the workshop level and the organizational conditions that shape, regulate, and sustain that interaction over time. From this perspective, facilitators’ and actors’ professional judgments are not exercised in isolation, but are embedded within leadership practices, training structures, and institutional arrangements that frame what counts as legitimate action, reflection, and learning. By foregrounding this micro–macro relationship, the study contributes to broader discussions in teacher education and practice-based learning on how professional knowledge is enacted within complex organizational settings, and how educational quality is shaped not only by what educators do, but by the conditions that make such practice possible and sustainable.

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