During a simulation scenario, students were divided into groups of 8-12 students who had worked with one another previously during group work. The students actively participated two and two during an actual simulation scenario. In the simulation room, one instructor was present with the students in order to provide guidance if needed. A second instructor was concealed behind a one-way screen and controlled the manikin and provided the patient voice and guided the scenario. A third instructor sat together with the remaining students who observed the simulation in a separate classroom via a video screen. Each simulation lasted approximately 20 minutes, followed by 25 minutes of reflection during debriefing. The students who participated in the actual simulation first told about their experiences and what they conceivably would have done differently. Those students observing the simulation were asked to focus on certain areas: interaction, implementation of the procedure and communication. Both the instructors and students were actively involved during debriefings.