Clinical simulation is used in nursing education and in other health professional programs to prepare students for future clinical practice. Simulation can be used to teach students communication skills and how to deliver bad news to patients and families. However, skilled communication in clinical practice requires students to move beyond simply learning superficial communication techniques and behaviors. This article presents an unexplored concept in the simulation literature: the exercise of moral imagination by the health professional student. Drawing from the works of Hume, Aristotle and Gadamer, a conceptualization of moral imagination is first provided. Next, this article argues that students must exercise moral imagination on two levels: towards the direct communication exchange before them; and to the representative nature of simulation encounters. Last, the limits of moral imagination in simulation-based education are discussed.

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In research ethics reviews, traditional approaches of research ethics boards (REBs) balance the risks with the potential for benefit of proposed studies, and this review process has been similar for health professions education research (HPER) as it has been for clinically based studies. Health professions students are the primary population from which most education researchers draw their participants although relatively little discussion has taken place in the literature regarding student participation in HPER. The majority of HPER studies could be considered minimal risk and therefore many have suggested that such studies be exempted from REB review. However, there are not only risks to student participants which require consideration, but I argue that when this issue is viewed through the lens of Aristotle's virtue ethics, there are also potential benefits to the student, for which REB oversight can be helpful, that have not factored strongly into discussions. This paper seeks to highlight the key factors involved in student participation in HPER; to explore Aristotle's doctrine of the mean and to evaluate how this ethical framework can add value to the discussion; and to propose possible applications of the Aristotelian mean to this issue and address some of the challenges that would arise with its application.