BACKGROUND AND PURPOSESimulation is an established method for building knowledge and ensuring competence in the aviation industry and military training.1 Health care simulation has been widely adopted in medical and nursing education with simulated experiences emerging in program accreditation requirements. Simulation is growing in use for health care staff development, including using simulations in the providers' practice environment. Physical therapy education has a long tradition of simulations, using standardized patients and role playing.25 Interprofessional and mannequinbased simulation in physical therapy education is a growing in popularity.68 Research in health care simulation consistently reveals the importance of sound debriefing strategies to realize the desired learning objectives.9,10In part, health care simulation has been driven by the increasing sensitivity and attention to inherent risk to patients posed by novice and inexperienced health care providers. Clinical training of physical therapy students is challenged by declining availability of clinical educational experiences and stipulations requiring close supervision of students.11,12 Clinical education cannot be scripted to present the range of situations that prompt the safe execution of skills and decision-making that a physical therapist (PT) must possess. Simulation can introduce the high risk/low frequency clinical events or highly sensitive patient interactions that have low tolerance for error within a learning experience that does not impose risk to actual patients. Furthermore, simulation allows feedback and repetition of events to achieve mastery. This practice can be aided by temporal manipulation of the experience with use of pause to think, rewind to a critical point, or a do-over following a suboptimal performance. Within clinical practice, simulation can also be a risk management strategy to revisit a breakdown of care, evaluate a near miss event, or rehearse a new workflow process.13 Simulation is particularly useful for developing team functioning.14Growing use of simulation in physical therapy education and professional development calls for an evidence-based approach. Best simulation practices require experiences purposely designed to expose the learner's frameworks, the cognitive foundation that directs clinical decisions and actions.15 Research in health care simulation has established essential conditions to create an effective learning environment. Simulation in medical education has demonstrated the importance of supporting realism, using prompts, effectively using confederates, and scripting key elements of the simulation. The key piece to participant learning is postsimulation debriefing, methods that serve to uncover and shape decision frame works. Ideally, a simulation is purposefully designed to expose any decision errors or performance gaps, which can then lend to fruitful debriefing. Various debriefing tools that have been developed and researched can be translated to physical therapy simulation. Evidenced-based simulation and debriefing strategies have the potential to sharpen skills and transform the learner's decision frameworks, which leads to durable improvements in clinical knowledge and competency.The purpose of this perspective is to justify the integration of simulation in physical therapy education and professional development. Simulation grounded in an evidence-based, pedagogical approach is a powerful learning tool independent of the technology available. The perspective will offer strategies, tools, and scripts that physical therapy educators can apply to their own simulations, leading to positive learning outcomes and replacing traditional instructional methods. Furthermore, simulation can support professional development for practicing PTs.POSITIONDespite its recognized value, the pedagogy and learning theory that supports simulation and debriefing is often overshadowed by simulation technology. …