[mncharity]

I wonder how changing technology might change system design tradeoffs and opportunities?

Better VR/AR, and event capture with lots of cameras, will blur the current gulf between "I saw it done" and "I saw a recording".

Medical simulation is improving and increasing. And some changes in medicine make it easier to simulate (arthroscopic, robotic). Changing optimal training mix.

Simulation big picture and long term... how will pilot training change, when even basic flight sim games are fully immersive environments with hands-on haptic controls? So how might medical training change, if a kid's "Operation" game includes AI patient interviews, playmate and automated-character resource management, and perhaps off-the-shelf haptics comparable to current med school sims?

Improving general education. This is more a social/political/systems change, but tech may help catalyze it. Let's see... a first-tier genetics course instructor says what they most wish their incoming students had learned, but haven't, from earlier undergraduate and pre-college bio courses, was simply a firm grasp of central dogma. Something that with good tooling, can be made accessible in early primary school. And I've talked with first-tier med students, who had no idea how big cells are, beyond "really really small". How might medical training change, if the education of its incoming students was failing less badly?

Apropos competency-based training, I years ago saw a proposal, I presume unimplemented, for a large-scale reentrant medical-training curriculum for India. Without having to start from scratch, an EMT could become a nurse, a nurse could train as a GP MD, an optometrist could level up to a non-surgical ophthalmologist, and so on. If our ability to do assessment improves, both simulation and non, then at least where there is a medical training shortage, perhaps there might be alternatives to quality control of training and practice being founded on institutional training-process controls.

[needlesurgeon]

Simulators are effective only as their verisimilitude. Certain neurosurgical procedures are well-reproduced using simulators (most notably the insertion of external ventricular drains[0] for hydrocephalus). Surgical simulation have also shown to be be effective in systems where the principle goal is to get the trainee used to getting visual and limited tactile feedback in specific settings, such as laparoscopic procedures. One thing that has been extensively explored is providing trainees biofeedback about their roughness of manipulating tissues. This in itself is useful; but, to use a musical metaphor, it's more like practicing scales than practicing a performance.

It turns out that recreating tissue in a VR environment that looks and feels like real tissue is a really hard problem. This is a growing industry, and I have no doubt that developers / biophysicists / clinicians will continue to produce more and more realistic systems. Frankly, we're just not there yet. Right now, there is no substitute for the real thing.

Put another way: imagine using a flight simulator where one couldn't reproduce the physics of a real plane. This would be somewhat useful, but have limited transference to actually flying a real plane.

[0] https://www.ncbi.nlm.nih.gov/pubmed/26115472