Training and assessment in obstetrics: the role of simulation.

Simulation is becoming an integral part of the training and assessment of obstetricians. Given the variety of manual skills that must be learned, awake patients and high-risk environment, obstetrics is uniquely suited for simulation. Simulation provides opportunities to rehearse and learn from mistakes without risks to patients. The use of simulation can help overcome some limitations of the current medical education and practice environment, including work-hour limitations and concerns for patient safety. Both low- and high-fidelity simulation models can be used to accomplish educational goals. Basic and advanced skills as well as the management of obstetric emergencies are amenable to simulation. For a simulation programme to be successful, one must identify the learner and the skills that are to be learned. In the future, simulation will be more available and realistic and will be used not only for education, but also for ongoing assessment of providers.