Regulatory bodies and healthcare commissioners arestarting to agree that using simulation, particu larly full immersion techniq ues, is better for both trainingand patientsafety. A World Health organi- zation patientsafety schoolsalso guideformedical made extensive reference to simulation. Realistic replication of clinical situations not only helps teach technical skills but can also give important insights into how individuals and teams behave and communicate, areas that have been repeatediy identified as commou sources of clinical errors Simulators are widely used in aviation, and the chief medical officer's report notes how trainee pilots are able to use the technology to recreate difficult situations and how established pilots must also fly regular simulator flights. But one of the key elements in the aviation industry's remark- able reduction in air crashes in the second half of the 20th century was the introduction of manda toy training in teamwork and human behavioural factors