Virtual reality simulation provides interesting opportunities to train nurses in a safe environment. While the virtual operating room has proven to be a useful training tool for technical skills, it has been less studied for non-technical skills. This study aimed to assess "Error recognition in a virtual operating room", using a simulation scenario designed to improve situation awareness. Eighteen scrub-nurse students and 8 expert scrub-nurses took part in the experiment. They were immersed in a virtual operating room and reported any errors they observed. There were nineteen errors with various degrees of severity. Measures were retrieved from logs (number of errors, time for detection, movements) and from questionnaires (situation awareness, subjective workload, anxiety and user experience). The results showed that the participants who detected most errors had a higher level of situation awareness, detected high-risk errors faster and felt more immersed in the virtual operating room than those detecting fewer errors. They also felt the workload was lighter and J o u r n a l P r e -p r o o f 3 experienced more satisfaction. Students explored the operating room more than experts did and detected more errors, especially those with moderate risk. Debriefings confirmed that virtual simulation is acceptable to trainees and motivates them. It also provides useful and original material for debriefings.

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Background. Courses are developed to train on open communication. This study focuses on speaking-up for scrub nurses.Method. The scenario is implemented on digital tablets, with vignettes involving problematic behaviours of a colleague with the same or different status. The nurses (N = 33) were asked whether they would point out the error, whether they would be embarrassed, and how they would do it.Results. Nurses expressed greater embarrassment with a colleague of a different status. This is confirmed by their phrasing and the strategies they reported when speaking to the surgeon. Conclusion.The scenario was well accepted and could be used to train other health professionals.