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Can simulators be used to assess clinical competence?

In the last 10 years, the use of simulation for training in the field of anaesthesia has been growing steadily. There are currently four centres around the UK that are using high fidelity simulators to train not only anaesthetists, but also surgeons, accident and emergency doctors, operating department assistants, intensive therapy unit nurses and house officers in both technical and non-technical skills (behavioural issues).