Intro -- Abstract -- Preface -- Thesis Contents -- 1 INTRODUCTION -- 1.1. Research Aim and Questions -- 1.2. List of Publications -- 1.3. Research Contributions -- 1.4. Assumptions -- 1.5. Reader's Guide -- 2 THEORETICAL BACKGROUND -- 2.1. Simulations -- 2.2. Theories of Cognition -- 3 EMERGENCY MEDICAL MANAGEMENT DOMAIN -- 3.1. Major Incidents and Surge Capacity -- 3.2. Pre-Hospital and In-Hospital Management -- 3.3. Medical Training and Assessment -- 4 RESEARCH APPROACH -- 4.1. Ethnographical Methods -- 4.2. Distributed Cognition for Teamwork: DiCoT -- 4.3. M& -- S Design and Development Cycle -- 5 APPLYING DISTRIBUTED COGNITION -- 5.1. Evaluating ETS Simulations with DiCoT -- 5.2. Simulator Development using DiCoT: DigEmergo -- 6 RE-INTERPRETING SIMULATION CONCEPTS -- 6.1. Human-Centered Simulations as Cognitive Systems -- 6.2. Interpreting Descriptive Attributes -- 6.3. Interpreting Validity -- 7 DISCUSSION AND CONCLUSION -- 7.1. Addressing Research Questions -- 7.2. Application of Human-Centered Simulations -- 7.3. Contributions as Products of Technological Research andScience -- 7.4. Limitations -- 7.5. Thoughts for the Future -- 7.6. Conclusion -- REFERENCES -- Papers.