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This study explores emotion regulation (ER) among Japanese medical students during team-based simulation training using the Japanese Simulation Emotion Regulation Questionnaire (J-SimERQ). The study involved 100 fifth-year students and measured their emotions before and after the simulations. Results indicated an increase in negative emotions post-simulation. The most commonly used ER strategies were attention deployment at the individual level and situation modification at the team level, with cognitive change being the least utilized. Positive emotions like pride were associated with better individual performance, while negative emotions like shame had a detrimental impact. These findings align with existing theoretical models, suggesting their applicability in the context of Asian medical education.