Computer-based virtual reality technology has evolved to the point at which medical simulation can be incorporated into medical education and into the eventual objective evaluation of surgical competence. Flight simulation provides a model for examining the role of computer-based simulation in medical training and certification. The plan by which medical simulators are being designed and validated for surgical training is presented, as is a description of the current state of medical simulation and the limitations of the technology. A realistic argument for adoption is suggested that takes into account lower price constraints, technological limitations, and professional barriers to the implementation of simulator-based training and accreditation.1

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