Simulation has progressively established itself as an essential tool in nursing education and in the training of healthcare professionals. It is recognized not only as a safe environment for acquiring technical skills, but also as a privileged context where to experience complex decision-making, relational dynamics and ethical dilemmas. Through the reproduction of realistic clinical scenarios, simulation allows students to learn experientially, supported by reflective processes such as debriefing and guided by simulation practitioners who supervise and accompany the learning journey.

However, the increasing use of simulation raises questions that go beyond its purely technical dimension, calling into question the ethical and pedagogical implications of this practice. The immersive and hyperrealistic power of simulation, while offering an opportunity for safe learning, also entails risks such as detachment from the complexity of real-life clinical practice, instrumentalization of diversity, psychological impact on participants and the reduction of educational relationships to mere performance-based logics.

In this context, simulation is not merely a teaching technique but an ethical practice space. Theoretical approaches to ethics—such as care ethics, virtue ethics and relational ethics—offer valuable frameworks to guide the design, delivery and debriefing of simulated scenarios. These perspectives remind us that students are not simply acquiring skills, but undergoing moral experiences that shape their professional identity and relational competence. Simulation thus becomes an opportunity to question not only what is done, but how and why it is done—promoting critical reflection, responsibility and ethical sensitivity.

This contribution aims to explore these issues by integrating recent scientific literature with the principles outlined in the Healthcare Simulationist Code of Ethics (Society for Simulation in Healthcare, 2018) and by enriching the analysis through philosophical and pedagogical reflections. The objective is to promote a vision of simulation that goes beyond the development of technical competence, fostering ethical responsibility, relational sensitivity and critical awareness, thus contributing to the education of healthcare professionals who are able to care with both humanity and expertise.