Simulation in Endoscopy.

Endoscopy training traditionally relies on patient-based apprenticeship, which can limit exposure, feedback, and patient safety. Simulation offers a safe, reproducible environment for skill development, with mechanical, virtual reality, and hybrid systems providing increasing realism, procedural variety, and objective metrics. Evidence shows simulation enhances early skill acquisition, structured learning, and trainee confidence, though its superiority over patient-based training and predictive value for real-world outcomes remains under study. Barriers include cost, faculty expertise, and integration into curricula. Future work should focus on long-term skill retention, linking simulation performance to patient outcomes, and expanding accessible, cost-effective platforms.