Transforming Simulation Practices—A Quest for Return on Expectations

A “model case” of a large multisite simulation program is described wherein the adoption of the revised Standards of Best Practice: Simulation (2013) offers a compelling argument for new paradigm development. The authors offer the use of return on expectations in addition to return on investment in the complex matter of program evaluation to identify value to organizations. Stakeholders must be engaged early to begin program evaluation, as Kirkpatrick suggests, with the end in mind. In this way, true transformation of simulation practices makes systematic and sustainable program evaluation more likely. •Standards of Best Practice: Simulation provided a solid framework to transform instructional methods in a large multisite program.•Excess variance between simulation center practices makes evaluation of effectiveness unreliable.•The introduction of return on expectations challenges the prevailing view that return on investment is the seemingly desired tangible measure of value.