A lot has changed since EMS began using healthcare simulation more than 45 years ago. Modalities such as manikins and role-play by faculty have evolved into an evidence-based practice where patient and provider safety has become of leading importance. Over the past 20 years, research has brought greater depth and breadth of understanding to the science of simulation by establishing best practice standards. 1 Preparing participants and attesting to competency for working or volunteering in the most uncontrolled, unpredictable patient care environments takes precision. Just as EMS has matured, so has the healthcare simulation profession. Simulation Best Practices The International Nursing Association for Clinical Simulation and Learning (INACSL) has published best practice simulation standards. These standards address core topics such as design, operations, debriefing, interprofessional education, and facilitation. The standards are regarded as the foundation for sound simulation experiences and have been adopted across health professions.