Simulation speak

The concept of using simulation to gain and improve practical skills in a safe and low-risk environment has been employed extensively in the airline industry to train pilots for many years now. The use of simulation techniques to train surgeons, however, is a new but rapidly expanding and developing area of surgical education. The introduction of simulation to surgical training curricula has inevitably led to a plethora of simulation technology entering the commercial market, as well as the introduction of new terminology used to describe both the equipment itself, and the methods used to test and validate it for use in the training of surgeons. The terminology has its basis mostly in statistical methodology, and the terms are used throughout the surgical literature, often interchangeably and with multiple meanings. In our experience, this terminology is where most confusion arises. Interpreting the literature is difficult for those not directly involved in the field. This article aims to define the statistical terms used to describe the many forms of validity testing and types of surgical simulator, and consequently to act as a reference guide for those unfamiliar with this rapidly evolving field of technology and surgical training.Katherine Fairhurst, Andrew Strickland and Guy J. Madder