Surgical simulation in pediatric urologic education.

The drive to achieve improved patient outcomes and patient safety has led to innovation in surgical education. The century-old teaching paradigms of "see one, do one, teach one" and training by opportunity are inappropriate in a surgical world of rapidly introduced advanced technologies. The need for improved surgical education methods is no more critical than in pediatric surgery, where the complexity of patient diseases and the physical size of the patients tend to challenge the limitations of existing surgical technology and skill. Surgical simulation offers extraordinary opportunities to teach multiple clinical scenarios in a safe, nonhuman patient environment where performance feedback is immediate and objective. Although minimally invasive surgical techniques (laparoscopic and robotic) are ideally suited for computer-assisted or virtual reality training, medical decision-making simulation for minimally invasive surgery and open surgery is in its infancy and, arguably, the most important aspect of effective surgical practice.