The current focus on patient safety and evidence-based medical education has led to an increased interest in utilising virtual reality (VR) for medical training. The development of VR-based systems require experts from different disciplines to collaborate with shared and agreed objectives throughout a system's development process. Both the development of technology as well as the incorporation and evaluation of relevant training have to be given the appropriate attention. Aim: The aim of this article is to illustrate how constructive relationships can be established between stakeholders to develop useful and usable VR-based medical training systems. Methods: This article reports a case study of two research projects that developed and evaluated a VR-based training system for spinal anaesthesia. Results: The case study illustrates how close relationships can be established by champion clinicians leading research in this area and by closely engaging clinicians and educators in iterative prototype design throughout a system's development process. Conclusion: Clinicians and educators have to strive to get more involved (ideally as champions of innovation) and actively guide the development of VR-based training and assessment systems. System developers have to strive to ensure that clinicians and educators are participating constructively in the developments of such systems.