Article Text

Download PDFPDF
A brief history of the development of mannequin simulators for clinical education and training
  1. J B Cooper1,
  2. V R Taqueti2
  1. 1
    Department of Anesthesia, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA
  2. 2
    Harvard-MIT Division of Health Sciences and Technology
  1. Dr Jeffrey B Cooper, Department of Anesthesia and Critical Care, Massachusetts General Hospital, 55 Fruit Street CLN 250, Boston, MA 02114, USA; jcooper{at}


Simulation for medical and healthcare applications, although still in a relatively nascent stage of development, already has a history that can inform the process of further research and dissemination. The development of mannequin simulators used for education, training, and research is reviewed, tracing the motivations, evolution to commercial availability, and efforts toward assessment of efficacy of those for teaching cardiopulmonary resuscitation, cardiology skills, anaesthesia clinical skills, and crisis management. A brief overview of procedural simulators and part-task trainers is also presented, contrasting the two domains and suggesting that a thorough history of the 20+ types of simulator technologies would provide a useful overview and perspective. There has been relatively little cross fertilisation of ideas and methods between the two simulator domains. Enhanced interaction between investigators and integration of simulation technologies would be beneficial for the dissemination of the concepts and their applications.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Competing interests: None declared.

  • * Good and Gravenstein refer to the very early roots of simulation, for instance to the medieval quintain, a mounted figure used for lance practice by horse mounted knights.1 There is a successful history of simulation in nonmedical domains, with aviation most often cited as the example to emulate. That experience has influenced the development of medical simulators, but is described elsewhere.2 3

  • This is a reprint of a paper that appeared in Quality & Safety in Health Care, October 2004, volume 13 (Suppl I), pages i11–i18. Reprinted with kind permission of the authors and publisher.

  • i As the original sources of many procedural trainers were from corporate research and development versus the generally academic source of most mannequin simulators, publications are less indicative of the chronology of development or appearance of specific technologies.