**3. Background of simulation in surgical training**

Surgical training involving Halstead's apprenticeship model has changed particularly with the uptake of laparoscopic surgery [15]. Patient safety, the ethics of learning and teaching surgical procedures to patients, the development of new technologies, and the need for objective assessment of trainees have meant simulation plays an important role in surgical training.

Given the breadth of technical and nontechnical skills required to perform laparoscopic surgery safely and efficiently, a variety of simulators have been developed. The aims of simulators assist surgeons in ascending the learning curve for specific procedures and provide skills that translate to improved performance and safety.

Simulation has been widely used, particularly in laparoscopic surgery (**Table 3**). Training models include benchtop models, virtual reality (VR), augmented reality (AR), animals, and cadavers. A number of studies have compared different training models with the pertinent finding being that a combination of models is more effective than one model-based training [16].
