Introduction/Background Learners access to simulation centres and availability of instructors are two important limitations to expanding simulation-based training (SBT). The technology for SBT with reflective debriefing facilitated remotely via videoconferencing systems is available. However, we know very little of its effectiveness. Aim: To compare the educational effectiveness of remotely facilitated (RF) and locally facilitated (LF) SBT. We hypothesized that learners would find the RF method less effective than the LF method based on self-reported effectiveness. Methods Using a mixed method, data were collected through questionnaires and semi-structured interviews of newly graduated nurses attending a standardized simulation-based course addressing the deteriorating patient on five separate occasions. The participants attended two hours of lectures followed by four pause-and-discuss scenarios of 25 minutes duration, one of which was facilitated remotely. All instructors were unknown to the participants prior to the SBT. After the scenario the participants completed a 16 item questionnaire evaluating their perception of comfort with the mode, the quality of the debriefing, instructor engagement, group dynamic and technical quality on a 5 point Likert scale (where 5=strongly agree). Twelve participants were interviewed by telephone. We report aspects from the interviews that were mentioned by at least one participant. Quantitative data were analysed with non-parametric statistics using STATA SE 12.1 software with a 5% significance level. Results A total of 129 participated in the study between April and May 2013 and filled out questionnaires. Twelve of these were interviewed. No significant difference in the ratings of the RF scenarios compared with the LF scenarios was found in any aspect. The lowest mean score for any question in either group was 4.3. This was supported by participant’s comments in the interview, although there was a tendency to favour the LF mode. How the instructor was positioned in the room for RF greatly influenced how comfortable the participants felt during the scenario. If they could see the instructor sitting behind desk writing notes, it felt like they were being assessed as opposed to sessions where only the upper part of the instructor was visible. Simply positioning of the microphone had great impact on how the RF scenario ran as the participants might have to walk back and forth to the microphone for the instructor to hear them clearly. The technical aspects of communicating via videoconferencing were not necessarily a barrier for asking questions. Conclusion This study did not identify significant differences in participant’s perceptions of the quality of SBT and debriefing between these modes across a number of factors. However, in the interviews they slightly favoured LF and we found that small details had a great impact on how comfortable the participants felt. The interview responses revealed factors such as position of the microphone and view of the instructor during RF that could be a source of distraction and potentially impact on the effectiveness of SBT. In our study the participants only had one RF scenario and for some participants it was their first simulation experience. The participants had little time to get familiar with the RF method and less time to familiarize with the room than those doing the scenario with LF. This may have influenced their perception of the method. The study did not closely observe the behaviours of the instructors and this presents an opportunity to expand our understanding in this area as skilled instructors may potentially adapt their interactive behaviours as they moved from one mode to another. Disclosures Laerdal Foundation for Acute Medicine DIMS has funding from Laerdal Foundation P was invited speaker at IMSH DIMS has a collaboration agreement with Laerdal, Peter heads the EuSim group, providing instructor courses DIMS has a collaboration agreement with Laerdal