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This chapter provides a broad overview of simulation in work-integrated learning (WIL). It discusses the theoretical foundations of simulation such as scaffolding, Kolb’s experiential learning model, and Dreyfus’s five-stage model of adult skills acquisition. The authors also explore the range of modalities of simulation in WIL to provide insight into the diversity of designs and applications with a focus on external stakeholder influence and engagement. The different design features unique to simulation in WIL are presented, incorporating external stakeholders, and enriched with a mini case study on a simulation-based remediation program for allied health students and examples from health and other fields. Intrinsic and extrinsic factors that may affect learner engagement in simulation are discussed. The chapter concludes with a consideration of the future directions of simulation and its place in WIL.