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Real-time, interactive simulators are used extensively for teaching pilots to employ the operational characteristics of their aircraft. Pilots can "fly " a multimillion-dollar aircraft without risk to the aircraft, other people, or themselves. They can encounter realistic scenarios to prepare them for actual flight situations. They can experience rarely occurring phenomena without risk, and prepare to react to problems before they occur. Medical errors are an increasing phenomenon in military and civilian healthcare systems. Medical simulations have gained widespread acceptance in the military, particularly in combat medical triage. But many medical professionals must react in emergency situations without the benefit of practice training. Rather, they must leam from real-life patient situations. The sophisticated medical procedure of operating the heart-lung machine during open-heart surgery operations is an example. Similar to pilots, perfusionists (the professionals who operate the heart-lung machine) must react to mUltiple variables, in hurried timed sequences, and in extremely stressful situations. Mismanagement of cardiopulmonary bypass can lead to death or increased morbidity of the patient. Lessons learned in the Air Force for training fighter pilots and other combatants are being applied to medical arenas to increase training effectiveness and to decrease the incidence of medical errors. Report Documentation Page Form ApprovedOMB No. 0704-018