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International audience; Purpose Training in Interventional Radiology currently uses the apprenticeship model, where clinical and technical skills of invasive procedures are learnt during practice in patients. This apprenticeship training method is increasingly limited by regulatory restrictions on working hours, concerns over patient risk through trainees' inexperience and the variable exposure to case mix and emergencies during training. To address this, we have developed a computer-based simulation of visceral needle puncture procedures. Methods A real-time framework has been built that includes: segmentation, physically based modelling, haptics rendering, pseudo-ultrasound generation and the concept of a physical mannequin. It is the result of a close collaboration between different universities, involving computer scientists, clinicians, clinical engineers and occupational psychologists. Results The technical implementation of the framework is a robust and real-time simulation environment combining a physical platform and an immersive computerized virtual environment. The face, content and construct validation have been previously assessed, showing the reliability and effectiveness of this framework, as well as its potential for teaching visceral needle puncture. Conclusion A simulator for ultrasound-guided liver biopsy has been developed. It includes functionalities and metrics extracted from cognitive task analysis. This framework can be useful during training, particularly given the known difficulties in gaining significant practice of core skills in patients.

This paper discusses the design issues and implementation details of building a medical training simulator. Example projects that have been undertaken by the Visualization and Medical Graphics group at Bangor University and our collaborators are used to illustrate the points made. A detailed case study is then presented of a virtual environment designed to train the Seldinger Technique, a common procedure in interventional radiology. The paper will introduce a medical practitioner to the technology behind a medical virtual environment. It will also provide an engineer with an overview of many of the issues that need to be considered when undertaking to build such an application. The paper ends with the author’s views on future developments in this exciting domain.