Making It Real: Development and integration of in situ simulation operating rooms into the real operating room environment

Simulation is any artificial construct that represents a real-world process. Technology-enhanced simulation in modern health care is growing exponentially, but the basic concept of ?practice? to enhance real-world performance in medicine dates back centuries. For example, in the 1600?1700s, birthing simulators were built from human bones, leather, wood, and wicker to train midwives how to manage common birthing emergencies [1].