Hidden identity simulation: Using secret character roles to practice navigating event medical team dynamics

Interdisciplinary medical teams often collaborate for the first time at mass-gathering events. Simulation helps participants navigate interpersonal dynamics. A gamified simulation could offer an engaging, low-stakes method to introduce emotionally charged topics like team conflict. Hidden Identity Simulation (HID SIM) is a gamified simulation where participants with randomly assigned secret character roles (e.g. ‘The Know-It-All’) navigate diverse personalities while managing a case. A debrief highlights team dynamic management strategies. A serotonin toxicity case was piloted using HID SIM in a simulation theatre. Twenty-nine participants randomly selected character cards that outline personality descriptions and conditions that modify character intensity. Participants responded positively, rating HID SIM 4.75/5 overall and 4.43/5 for engagement (<i>n</i> = 28). ‘Less stressful than anticipated’ scored 3.54/5 (<i>n</i> = 28), and ‘less stressful than other simulations’ was rated 3.68/5 (<i>n</i> = 19). Participants rated their pre-/post-simulation self-efficacy in several teamwork and medical competencies. All competencies showed statistically significant increases (<i>p</i> &lt; 0.001) post-simulation. Future steps include writing new character cards, expanding HID SIM to other clinical settings, and designing customized decks targeting specific team dynamics.