Accomplishments and challenges of surgical simulation - Dawning of the next-generation surgical education

For nearly a decade, advanced computer technologies have created extraordin ary educational tools using three-dimensional (3D) visualization and virtua l reality. Pioneering efforts in surgical simulation with these tools have resulted in a first generation of simulators for surgical technical skills. Accomplishments include simulations with 3D models of anatomy for practice of surgical tasks, initial assessment of student performance in technical skills, and awareness by professional societies of potential in surgical ed ucation and certification. However, enormous challenges remain, which inclu de improvement of technical fidelity, standardization of accurate metrics f or performance evaluation, integration of simulators into a robust educatio nal curriculum, stringent evaluation of simulators for effectiveness and va lue added to surgical training, determination of simulation application to certification of surgical technical skills, and a business model to impleme nt and disseminate simulation successfully throughout the medical education community. This review looks at the historical progress of surgical simula tors, their accomplishments, and the challenges that remain.