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The introduction of laparoscopic technique in pelvic surgery has improved patient outcome and reduced the impact of surgery on the patients’ quality of life. At the same time, the requirements for surgeons have changed profoundly. Traditional surgical training cannot meet the complexity of laparoscopic pelvic surgery and demands of high quality outcome. Simulation training is effective for both basic and advanced laparoscopic skills. There is a need for new training models for surgeons where simulation is an integral part of the training. Clinical training is more efficient when combined with simulation. New concepts of training e.g. mental training have shown great potential to further improve learning curves in combination with simulation.

Instructional methods that aim to optimize teaching outside of the operating room are becoming increasingly important due to the reduction in traditional hospital training hours. One such method is the use of multimedia-based portable learning tools. In developing these tools, due consideration should be given to the features that define effective multimedia and the core surgical skills suited to this form of instruction.

The performance of professionals in the health-care or any other industry is subject to human error. The acknowledgment of human error as ubiquitous and inevitable is the key premise for understanding the importance of human factors. Nontechnical skills (NTS) can improve performance, and attempts have been made to quantify this ambiguous quality. The implementation of NTS into training is possible as experience from flight crew training and aircraft maintenance personnel show. A number of factors that influence human performance negatively have been identified. For instance, stress and fatigue have a negative impact on the performance of surgeons, although this effect to a large extent is neglected among surgeons. Simulation training can facilitate NTS training by integrating elements of, e.g., stress in a simulated environment and thereby prepare surgeons for challenges in patient care and improve surgical training.

Checklists are the foundation for safety and quality control in the aviation industry. The concept developed from a disaster in 1935 and to date checklists are a dynamic tool within aviation and aircraft maintenance, regularly audited and adjusted to prevent avoidable error or accidents. Other high-risk industries such as nuclear and oil drilling industries have adapted the checklist principle as a means to improve safety. The recent introduction of the WHO checklist for safe surgery has demonstrated a reduction in perioperative mortality and morbidity and has led to an implementation on a grand scale around the world. The checklist principle though is not novel to health care, many hospitals have used preoperative checklists for years. Critics have therefore dismissed the WHO checklist as “the emperor’s new clothes.” However, the initial results of the WHO checklist should encourage surgeons to implement checklists as a tool for quality control toward safety-oriented health care.