Medical education: simulation and virtual reality

II Medical training in general, and surgical training especially, has always been based on learning the theory, followed by clinical experience gained through students' direct contact with patients. Technological evolution within education is progressively but definitively giving rise to a new stage in this process: simulation. Simulation as a form of learning gained strength in the 1930s through the popularization of the first flight simulator, which was known as the " Link Trainer ". The idea of teaching in simulated situations quickly drew the attention of people involved in teaching medicine, but because of the technical difficulties and cost, no great advances were viable at that time. The first simula-tor within medicine that achieved widespread acceptance was developed at the beginning of the 1960s by Åsmund Laerdal, a manufacturer of plastic toys. His simulator consisted of a dummy that was designed to provide training for mouth-to-mouth resuscitation; it became known as " Resusci Anne ". It was so successful that the product continued to be refined over the years, to reach the present day with a variety of improvements that enable effective training for dealing with cardiorespiratory arrest. 1 The history of computing and virtual reality in medical training began with a theoretical proposal for a man-machine graphical interface called the " Sketchpad " , made by Ivan Suther-land in the 1960s. Nevertheless, advances in this field only started to accelerate in the 1980s, with the proliferation of computers and peripherals. In 1989, two NASA (National Aeronautics and Space Administration) employees presented the device that became known as the first computer-based surgical simulator. This device could be used for simulations on orthopedic procedures, such that the biomechanical consequences of these procedures could be studied on the computer. 2 The interest in this subject among the medical community can be gauged from the large number of papers relating to this that are available in the literature. Today, a search in the PubMed database using the term " medical simulation training " retrieves a total of 4,360 articles. The first of these dates from the 1960s, with a notable increase in concentration over the last few years. The literature provides information on viable and efficient models and simulators destined for teaching about cardiopulmonary resuscitation, vascular accesses, video laparoscopy, anesthesia procedures and techniques within obstetrics, endoscopy and orthopedics, and so on. In addition to the papers describing the various methods, such as the …