Simulation has been used for many years to train aviation and military personnel for work in hazardous environments. Effective and safe performance in these settings requires both highly skilled individuals and a high degree of team coordination. In addition to individual competence, communication between team members and decision making become particularly important during the management of crisis scenarios. Over the past few years several articles have described the use of simulations, simple and computer based, for the acquisition of technical skills in surgery, endoscopy, and anaesthesia. 1^–3 The focus has largely been on the acquisition and assessment of individual technical skills, but now the role of simulations in training teams to work with a greater degree of coordination is being acknowledged.

Simulations are beginning to play an important part in the training of personnel in the operating theatre, emergency department, and the obstetric suite.3 ^{w1 w2} For …