Computer-based clinical simulations are a powerful teaching and learning tool because of their ability to expand healthcare students' clinical experience by providing practice-based learning. Despite the benefits of traditional computer-based clinical simulations, there are significant issues that arise when incorporating them into a flexible, co-operative and collaborative learning environment. Unlike traditional technologies; immersive multi-user virtual environments such as Second Life can incorporate comprehensive learning materials with effective learning strategies, allowing healthcare students to obtain a simulated clinical experience in an immersive social environment. The purpose of this research was to investigate how a simulation could be optimised in Second Life to encourage teamwork and collaborative problem solving based on the habits, experiences and perceptions of nursing students towards Second Life as a simulation platform. The research was conducted by placing groups of nursing students in separate locations and exposing them to a series of clinical simulation developed in Second Life. The simulation involved a series of problem-based scenarios, which incorporated concepts of technical skills, patient interaction, teamwork and situational awareness. Using qualitative feedback from a series of evaluative case studies, the study determined good practices and issues involved with a virtual computer-based clinical simulation. A common theme which emerged from this research, which is discussed in this paper, was the student's ability to work in an artificial social structure where they could actively co-construct mental models of technical and interpersonal skills through experiencing human interaction in a computer-based simulated environment.