Simulation in healthcare has evolved from a focus on individual skills training to a broader set of applications spanning education and cultural and systems-level change. Yet conceptual clarity remains lacking, particularly in how Simulation-Based Education (SBE) and Transformative Simulation (TfS) relate, given that they stem from different philosophical orientations and theories. This essay proposes a conceptual bridge between these two purposes of simulation, grounded in the meta-theory of transformative pedagogy. While SBE draws on diverse theories and concepts to support learning, TfS emphasizes collaboration, systems thinking and user engagement to drive collective understanding, insight and change. We use a metaphor of a bridge to illustrate the passage for a bi-directional model showing how SBE can lead to transformation and how TfS insights can be educationally embedded. This offers a cohesive structure positioning simulation as a tool for individual, interprofessional and cultural and systems-level development and reform.
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