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The background of this study is an interest in simulations in healthcare training, especially in the roles that operators and facilitators play when staging and supporting learning activities. The study builds on interaction analysis of 30 video-documented (15h) conversations at three advanced simulator suites. Findings document the nature of the multidimensional work performed by operators/facilitators when engaging in this complex activity of monitoring, orchestrating and supporting professional learning. The interventions range from considering in situ how and when to intervene with triggers, prompts or by manipulating the technical equipment, to noticing what to bring up in the debriefing. The study demonstrates how sophisticated technologies create new interdisciplinary professional skills necessary to exploit the learning potentials of advanced forms of simulations.