AANA journal course: update for nurse anesthetists--anesthesia simulation: a tool for learning and research.

High fidelity simulators are a new technology for training and research in anesthesiology. The simulators accurately replicate the anesthetist's entire work environment, including the patient, anesthesia machine, monitors, and drugs. The trainee is allowed to develop and refine his skills in anesthesia management in a safe and realistic environment. By tailoring the scenario, both basic and advanced management skills can be taught. Learners can be exposed to serious or uncommon anesthetic events which they may not otherwise see during their training. Videotaping and case logs provide unbiased recording of the session. Simulators also allow the use of new instructional techniques that are untenable in a real operating room, such as allowing critical incidents to develop fully to teach management skills or redoing cases that were poorly handled. Allowing the student to make critical errors, pausing the simulation to discuss management, or replaying the case with different management techniques are valuable teaching tools. Research studies in human performance, learning and cognition, and anesthesia crisis management training are currently underway and may produce improved training methods for novice and expert anesthesia practitioners alike.