Simulation is a powerful tool for education. It recreates - without pitfalls or irreversible sequelae - the environment in which a professional works, enabling the trainee to practise essential skills without having to worry about the consequences of failure. It has repeatedly proven its value in training for high-risk, mission-critical tasks, for which training is required, but opportunity limited by danger, prohibitive cost, or extreme impracticality. In these situations, simulation allows for risk-free training, providing a non- threatening environment in which trainees, not yet achieving proficiency, may practice a skill with the freedom to fail, without entailing unpleasant consequences, or squandering consumable materials. To take advantage of the power of simulation in surgical training, curriculum development must be informed by training needs analysis, with simulation development and deployment driven by educational principle rather than technological availability. Training for a variety of skills, tasks, and procedures needs to be matched to appropriate training media for simulation to be an efficient educational strategy.