Simulation allows surgical trainees to develop technical skills (TS) and non-technical skills (NTS) in reproducible environments without compromising patient safety [1]. The Halstedian model of apprenticeship-based learning has traditionally been used to achieve competency in ophthalmic surgery, however, factors such as workforce redeployment and suspension of elective surgery secondary to COVID-19 have compromised learning and skills progression [2]. Trainees may not achieve their mandatory 350 cataract procedures, or be adequately experienced with managing complications such as posterior capsule rupture (PCR) by the end of their training [2]. Simulation-based training modalities could be used to mitigate these issues, however, few are immersive, NTS focussed, or are used within scenario-based settings [3]. This article explores the role of simulation in cataract surgery training, the educational theory underpinning simulation-based scenarios, and perceived barriers to implementation.

Simulation in aviation is mandatory and routine; pilots obtain basic and advanced TS and NTS through simulator training, and continue to be assessed in simulated settings for the remainder of their careers [4]. Simulators allow pilots to rehearse managing emergencies (including engine failures and rapid decompression) in preparation for their real-world occurrence [4]. NTS failures contribute to 70% of incidents and accidents in aviation, and simulation-based NTS training has greatly improved safety standards in aviation in recent decades [5, 6]. NTS failures are frequently implicated in cataract surgery complications and errors, including wrong intraocular lens events [5]. The NTS required for managing intraoperative emergencies can be trained and rehearsed through simulation [7, 8].

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