Dear Editor-in-Chief,

I am writing to raise concerns regarding the publication of the single-page ‘Key Concepts’ article entitled ‘Transformative simulation’ [1].

While conceptual contributions are welcome within healthcare simulation scholarship, this publication raises critical issues relating to attribution, theoretical lineage, evidentiary standards and the role of peer-reviewed journals in maintaining academic rigour.

First, Weldon’s framework is presented as grounded in an international evidence base. However, it is presented without meaningful engagement with the substantial body of simulation scholarship that has developed over the past decade. As one example, translational simulation, as articulated in peer-reviewed literature since 2017, is explicitly grounded in safety science, implementation science, systems thinking, human factors and organizational theory [2–9]. From its earliest formulations, it has encompassed relational work, leadership, culture and system-level change and demonstrated impacts at these levels [10–13].

The absence of meaningful lineage to well-established frameworks in Weldon’s work creates a misleading impression of conceptual novelty. The ideas presented in the transformative simulation framework are not new. Academic progress is cumulative. Frameworks that build upon established ones should explicitly acknowledge their foundations and clearly articulate how they advance, refine or differ from existing models. Without this link, Weldon’s work risks fragmenting an already mature field and obscuring its intellectual history.

Second, the primary evidentiary foundation for Weldon’s ‘framework’ appears to be the Seven ‘I’s’ taxonomy [14]. The origins of the other dimensions are unclear. Unfortunately, the taxonomy itself has not undergone robust, sustained academic scrutiny. The journal in which it was originally published is no longer operational, limiting opportunities for post-publication critique and debate. The methods described in the original taxonomy raise legitimate concerns: the search strategy was insufficiently transparent and inclusive (commentaries and reviews where conceptual advancement often happens were excluded); the analytic process lacked a clear audit trail; and the categories appear to have been largely pre-determined rather than systematically derived. The resulting categories (i.e improvement vs. intervention and involvement vs. inclusion) demonstrate substantial semantic overlap and are not mutually exclusive. Sound taxonomies require categories that are conceptually distinct [15,16]. Weldon’s taxonomy doesn’t seem to meet the basic criteria of the genre.

The taxonomy also seems to behave like a chameleon, shifting between descriptive classification and prescriptive guidance. Transformative simulation has been presented as a taxonomy [14], a framework [1], a leadership method [17], an infographic [18], a blueprint, an architecture and a cultural intervention with shifting descriptors across publications, websites, social media platforms and videos. These blurry multiplying roles and purposes erode its utility.

Third, the format of this current publication is problematic. Weldon’s piece appears as a single-page infographic with minimal methodological exposition, no theoretical comparison and no substantive analytic argument. While infographics can serve as useful adjuncts, publishing a new ‘framework’ in this format within a peer-reviewed journal effectively elevates its status without subjecting it to the level of scholarly interrogation typically expected of framework development. This can now be easily cited in future publications. Frameworks that seek to guide practice warrant detailed theoretical grounding and transparent analytic justification. This feels like advertising not scholarship. For readers looking for robust guidance to support their simulation practice, I suggest references 2–9.

As the field matures, standards of attribution and conceptual clarity must mature with it. When frameworks closely resemble established approaches but are presented as novel without explicit differentiation, the consequence is not merely duplication but erosion of scholarly trust.

The issue here is not one of disciplinary rivalry or semantic preference. It is about intellectual integrity and scientific precision. Journals serve as custodians of academic standards. I respectfully encourage JoHS to consider whether this framework has been sufficiently contextualized within existing scholarship and whether further scholarly dialogue (such as an invited commentary or debate) would strengthen the integrity of the publication.

Healthcare simulation deserves rigorous, cumulative science. Conceptual innovation is welcome, but it must be methodologically sound and transparently situated within the work that precedes it. Weldon’s ‘Key Concept’ is neither.

Sincerely,

Eve Purdy