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

Virtual reality simulations in medicine present a variety of technical challenges that differ from those associated with flight, space, and battlefield simulations. One imposing barrier to the widespread adoption of medical simulators is the lack of software tools that could enable medical content developers to author simulations in their respective disciplines. Our experience in developing custom standalone virtual reality applications in medicine has provided the basis for the development of Teleos™, a software toolkit for authoring interactive simulations in medicine.