As ASPiH (Association for Simulated Practice in Healthcare) celebrates its 15th anniversary at this year’s conference, there is an opportunity to reflect on how simulation in healthcare has changed. Although simulation in healthcare has been around for centuries [1], it is really only in the past few decades that we have seen its legitimacy, integration into healthcare and education, and purposes become more established [2]. Recent growth has been exponential and with that has come further insights and opportunities to shape, refine and advance simulation in all its forms for the benefit of all.

This year’s ASPiH conference theme is that of Transformative Simulation [3,4]. The theme reflects not only a distinct purpose for simulation but also acknowledges how simulation has transformed over time. We are commonly used to seeing healthcare simulation used as a tool for education but more and more we are seeing the benefits of simulation as ‘a tool to transform health and care through collective understanding, insight and learning’ [3,5]. This distinct purpose offers many opportunities to transform healthcare – even disruptively – rather than replicating existent practices. However, without recognition of this distinction, advances are slow and confusion can persist.

Simulation designed for education serves a fundamentally different purpose to simulation aimed at eliciting insights and knowledge to drive transformational changes. That becomes strikingly evident when designing simulations for these very different purposes. For example, educational simulation requires pre-determined learning outcomes [6], whereas transformative simulation requires broad objectives that enable understandings and insights to emerge [7]. Simulation for education draws predominantly on learning theories [8], whereas simulation for transformation draws on a wider range of practice-based theories: improvement, human factors and engagement to name a few [9–11]. Simulation for education often focuses on the achievement of the pre-defined learning outcomes [12], whereas transformative simulation focuses on discovering actionable outcomes that lead to real-world changes [13]. Debriefing in educational simulation is more introspective, often centred on the individuals’ learning and development [14], whereas debriefing for transformation tends to be more extrospective and aiming to generate wider knowledge to drive collective action [15].

The seven simulation-based interventions (SBIs) within the Transformative Simulation framework (Figure 1) allow us to categorize the driving objectives of simulation for transformation. The taxonomy recognizes all the remarkable work that has been and is being done for this distinct purpose, and allows us to share examples, outcomes and learning – making it easier for others to adopt and advance. It touches on the main theme of previous ASPiH annual conferences in terms of diversity with its Inclusion element and sustainability which is applicable in several I’s such as Innovation, Improvement and intervention [16,17]. Additionally, it provides clarity and legitimacy to those unfamiliar with the different applications and purposes of simulation as a tool or probe. We appreciate that many are still becoming familiar with this distinction and, therefore, as an association, we have created resources and established a specialist interest group (SIG) dedicated to advancing this knowledge. This SIG is open to and welcomes anyone with similar interests: https://aspih.org.uk/transformative-simulation-resources/

Figure 1:

The seven interventions of the Transformative Simulation Framework [3].

As we celebrate the 15 years of ASPiH, we are acutely aware that this is just the beginning of what we believe healthcare simulation can achieve. With emerging technologies, increased scholarly understanding and advancements, and the contributions of imaginative and innovative thinkers, the future possibilities are limitless – what we do know is that these are exciting times for the healthcare simulation community as we learn and explore what simulation in healthcare is capable of, and demonstrate its full potential to the world.

We, therefore, invite you, in the inclusive spirit of the transformative simulation rainbow, to celebrate the past and the future of healthcare simulation at the ASPiH Conference in Edinburgh, 3–5 November 2024 (Figure 2), which has a vibrant and rich scientific programme based around the community’s scholarly and practical work in education, transformation and technovation – much of which has been selected for publication in this special issue of the Journal of Healthcare Simulation.

Figure 2:

Logo of the 15th annual conference of the Association for Simulated Practice in Healthcare.