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Simulation based assessment (SBA), assessments in which examinees interact with a human simulator, are increasingly prevalent in assessment in the professions and in education. Human simulators are trained provide a standardized assessment while also responding to nuanced differences between examinees and ensure that simulations are realistic. By definition, SBA implementation involves the cognition both of the examinee and of the human simulator. Yet the effect of the human simulator on the validity of SBAs is rarely examined. This study uses interviews and cognitive laboratories to understand the effect of one human simulator on the validity of one assessment and also presents test development methods that take advantage of simulator cognition in support of test validity.