Simulation applications have become increasingly common in health care. A convergence of factors has stimulated this growth, including the rapid advance of enabling technologies, demand for improved outcomes and objectively assessed competencies, and translation of lessons learned from other high-risk industries as a function of the patient safety and quality movements. The bulk of the experience gained and resources expended has been focused on education, training, and assessment of clinicians’ knowledge, skills, and attitudes. Simulation methods lend themselves to supporting human factors and systems-level investigations, yet work in health care has, to a large degree, been limited to a few experienced centers, interdisciplinary research teams, and isolated novel studies.