Nurse education has traditionally relied on clinical placements to provide nursing students with the 'hands-on' experience that is not possible to teach in a classroom setting. However, with changes to the NHS this is becoming increasingly difficult, with fewer resources available and issues of patient safety to consider. Hennman and Cunningham (2005) recognize there is a significant gulf between the theoretical component taught in the classroom and the complex realities of clinical practice. Cave (2005) has suggested the move into higher education has hindered rather than helped the linking of theory and practice in nurse education, because many nurse teachers are far removed from clinical practice and therefore no longer competent or clinically credible to be able to teach up-to-date clinical skills. In Scotland the Practice Education Facilitators role in integrating theory with practice is essential for both the NHS Trusts and higher education institutes. It would appear that these clinicians are the lynchpin between linking university work with the harsh realities of daily practice. If nurse education is to provide effective clinical skill simulation then it must also provide effective teachers who are up to date with current practice. In many cases this will not be the nurse teacher.