Introduction:

The Association for Simulated Practice in Healthcare (ASPiH) annual conference is held in Bournemouth, England from the 11^th to the 13^th November 2025. The three-day conference includes more than 170 poster presentations, 75 oral presentations, and 42 workshops. As can be seen from the published abstracts, a wide range of topics are addressed concerned with simulation education, technical innovation, and the use of simulation for transformation. Presenters and attendees come from a wide range of healthcare professions and specialties from across the UK, Ireland, and internationally, with participation from more than 15 countries spanning all 5 continents. This global participation underscores the theme of the conference: Simulation for Impact. More specifically, the impact of simulation on culture, co-production, and creativity.

Impact of simulation on culture:

Culture has been described as a slippery and ubiquitous concept [1]. This statement reflects the fact that there is no one agreed definition of culture, and the meaning has shifted over time. An anthropological definition of culture is “the socially transmitted knowledge and behaviour shared by some group of people” (p.23) [2]. The behavioural component of culture means that it is something that can be influenced through healthcare simulation. There are many examples of the use of simulation to impact the organisational culture. It has been suggested that in-situ simulation is particularly suited to providing valuable insight into both how ‘work is done’ and the related cultural aspects of the work in a healthcare unit [3]. There are also examples of the use of simulation to address specific aspects of organisational culture: such as safety culture or patient safety culture. For example, a Danish study found an improvement in healthcare providers’ perceptions of patient safety culture of healthcare providers following an in-situ simulation intervention [4].

An approach to using simulation to impact culture relates to improving the cultural competency of healthcare providers. Cultural competency is concerned with addressing barriers to the accessibility and effectiveness of health care services for people from racial or ethnic minorities [5]. In more recent years this concept has also been expanded to include language, sexual orientation, gender identity, class and professional status [6,7]. A systematic review of 27 papers concerned with providing simulated participant cultural competency education to student healthcare providers found that the intervention improved the cultural competence and confidence of learners [8]. More recently there has been a move away from cultural competence to cultural humility [9]. This is due to a recognition that culture perceived from a competency perspective implies that there is an endpoint to understanding culture when in reality it is fluid and requires an open and self-aware position [9,10]. Using simulation to improve cultural humility has great potential to promote equitable treatment of different cultural groups, and support culture differences across the healthcare system [9].

Impact of simulation on co-production:

Co-production is an approach used to meaningfully integrate the knowledge, expertise, and experience of healthcare users into the design and delivery of healthcare services and research [11]. A distinct feature of co-production is that it does not distinguish between healthcare providers and recipients. This is achieved by reducing the social distance, knowledge, and power imbalances between different participant groups in the co-production activity [12]. It has been suggested that although co-production has great promise, it may be limited due to the risk of entanglement in existing involvement frameworks and practices [13]. Simulation offers an approach to address this limitation by providing a forum to support co-production. To illustrate, a systematic review of co-production in nursing and midwifery education identified 23 studies. It was concluded that there was preliminary evidence that participatory approaches can improve learning and positively impact on nursing and midwifery students, service users, and carers [14]. Additionally, simulation has been used to co-produce new models of care, generate more integrated care, and bridge gaps in understanding [15,16,17]. However, co-production within simulation remains limited with no clear definition of co-production within the context of healthcare simulation [18].

Impact of simulation on creativity:

Creativity is integral to simulation. The range of simulation applications covered in the abstracts, posters, and workshops at ASPiH 2025 is a clear demonstration of the creativity of the community. Simulation has been described as ‘theatre with purpose’ [19]. This theatre analogy is very apt and recognises the creativity and imagination required to design and deliver simulation activities. However, this is only one aspect of simulation creativity. Increasingly simulation is also being used to impact health and care through collective understanding, insight, and learning garnered from transformative simulation approaches [20]. A visit to the ASPiH conference exhibition hall demonstrates the creativity of the simulation industry and the resulting sophistication and realism of the latest simulator technologies. It is therefore important to recognise that simulation is as complex as healthcare and more, and therefore designing it requires collective creativity to ensure it is intentional and impactful.

Conclusion:

Although the use of simulation in healthcare might seem a relatively recent phenomenon, simulators have, in fact, been used to support the education of healthcare professionals for thousands of years. It has been suggested that the 20^th century was a ‘dark age’ for healthcare simulation as compared to the previous two centuries [21]. Yet, the range of presentations, workshops, and industry stands at the APSiH 2025 conference suggest that we are now in a new and exciting age of healthcare simulation. One where the convergence of different cultures, co-production, and creativity is possible if we align with purpose.

Acknowledgements:

Thank you to everyone who responded to the call for abstracts for this year’s ASPiH conference and to the scientific committee members involved in the reviewing process.

Declarations:

Authors’ contributions. POC conceived and wrote the first draft of the article. All other authors reviewed and contributed to subsequent drafts of the article and approved the final version.

Funding. None declared.

Availability of data and materials. Not applicable

Ethics approval and consent to participate. Not applicable

Competing interests. None declared.

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