Optimizing vascular surgery training and outcomes using simulation

Simulation has emerged as a transformative force in vascular surgery, evolving from ancient training practices to high-fidelity, data-driven platforms that enhance education, team performance, and healthcare systems improvement.This review traces the historical evolution of simulation and evaluates its role in contemporary vascular surgery training, where it addresses the limitations of traditional apprenticeship models and supports competency-based assessment.Simulation enhances technical skill acquisition, enables safe repetition of complex procedures, and improves non-technical team-based performance, particularly in high-stakes scenarios.Additionally, simulation-based methods-such as Simulation of Adverse Outcomes (SAO)reveal system-level vulnerabilities that conventional root cause analyses often miss.Despite challenges such as cost, faculty training, and psychological safety for learners, the future of simulation is promising.Innovations including digital twins, AI-enhanced platforms, and integration with Health Systems Science are poised to expand simulation's impact from procedural training to organizational resilience and quality improvement.This review calls for simulation to be adopted as a core strategy-not merely an adjunct-in advancing safety, performance, and innovation in vascular surgery.