Background Simulation in nursing education is widely used to develop technical competence, yet its theoretical framing often neglects deeper ontological dimensions of learning. Purpose This article reconceptualizes simulation as an ontological pedagogy that fosters professional identity formation beyond procedural skill. Methods Drawing on phenomenology, transformative learning, and threshold concepts, this paper introduce the Simulation as Ontological Nexus of Transformation (SIM-ONT) Framework, supported by an integrative review of literature and conceptual analysis. Findings SIM-ONT comprises five interrelated dimensions, liminality, embodiment, relationality, moral activation, and professional becoming, that position simulation as a transformative space where learners negotiate uncertainty, ethical complexity, and identity shifts. Conceptual vignettes illustrate how simulation activates moral agency and presence, moving beyond performance metrics to cultivate reflective, ethically grounded practitioners. Conclusions Reframing simulation through an ontological lens expands its pedagogical purpose from technical rehearsal to holistic formation. SIM-ONT offers educators practical strategies for scenario design, debriefing, and curriculum integration that prioritize identity development and moral resilience. This theoretical contribution invites future research to explore ontological phenomena in simulation and operationalize identity-focused outcomes in nursing education.
Al-Hassan et al. (Fri,) studied this question.