Simulation and the future of military medicine.

The U.S. military currently faces serious difficulties in training medical personnel in peacetime for the tasks of war. The military beneficiary population comprises fit young service men and women, their dependents, and retirees. Their peacetime care, although vital, does little to prepare military medical personnel for war. Medical commanders have instituted an array of training programs to compensate for this shortfall, but there remains a large gap between operational medical needs and training opportunities in peacetime. The military has begun to examine whether simulation can fill this gap. An array of commercial, off-the-shelf technologies are already being used with varying degrees of success, and major initiatives are under way in both academia and industry, supported by the military, to develop virtual reality products for combat medical training. Even as the military exploits emerging technology and begins to articulate a simulation strategy, there is a growing interest in civilian medicine in the potential for simulation to affect patient safety--how medical simulation might mitigate the injuries and deaths caused by medical errors--and how it might also improve the quality of medical education and training.