Health simulation through the lens of self-determination theory - opportunities and pathways for discovery.

Health simulation is broadly viewed as an appealing, impactful, and innovative enhancement for the education and assessment of health professions students and practitioners. We have seen exponential and global growth in programmes implementing simulation techniques and technologies. Alongside this enthusiasm and growth, the theoretical underpinnings that might guide the efficacy of the field have not always been considered. Many of the principles that guide simulation design, development and practice have been intuited through practical trial and error. In considering how to retrofit theory to practice, we have at our disposal existing theories that may assist with building our practice, expertise, identity as a community of practice, authority and legitimacy as a field. Self-determination theory (SDT) is an established and evolving theory that examines the quality of motivation and human behaviours. It has been applied to a variety of contexts and provides evidence that may support and enhance the practice of health simulation. In this paper, SDT is outlined, and avenues for examining the fit of theory to practice are suggested. Promising links exist between SDT and health simulation. Opportunities and new pathways of discovery await.