Simulation technology is increasingly being used in nursing education. Previously used primarily for teaching procedural, instrumental, or critical incident types of skills, simulation is now being applied to training related to more dynamic, complex, and interpersonal human contexts. While high fidelity human patient simulators have significantly increased in authenticity, human responses have greater complexity and are qualitatively different than current technology represents. This paper examines the texture of representation by simulation. Through a tracing of historical and contemporary philosophical perspectives on (...) simulation, the nature and limits of the reality of human health responses represented by high fidelity human patient simulation (HF‐HPS) are explored. Issues concerning nursing education are raised around the nature of reality represented in HF‐HPS. Drawing on Waks, a framework for guiding pedagogical considerations around simulation in nursing education is presented for the ultimate purpose of promoting an educative experience with simulation. (shrink)