“…This technology requires educators to design curricula and evaluation rubrics and to document the validity of the educational environment. [241][242][243][244] Although much of the initial research focused on technical skill training and assessment, 36,38 recent evidence supports simulation for team training and the development of nontechnical skills. 231,243,245,246 Simulation also allows the scientific testing, without exposing a patient to risk, of the effect of human factors (eg, fatigue, stress) on technical skill, 43,247,248 communication patterns September 3, 2013 during crisis, 240 testing of educational methods, 249 and the relationship between technical and nontechnical skills 35,250 or between teamwork and clinical performance.…”