Medical simulation mimics clinical care, allowing individual health professionals and teams to develop and maintain skills necessary for safe and effective clinical care. It enables trainee surgeon practice remotely from patients thereby gaining confidence and becoming more efficient. One of the earliest examples of simulation is the construction of the game of chess in the sixth century for military training. In the last 10 years, technological advances have allowed for a wider availability and greater realism of simulation, and this has encouraged a great expansion in its use. The Experiential Learning Theory (ELT) developed by David Kolb (1982) ‘comes alive’ and explains well how simulation translates to deep learning. For operative gynaecology to fully take advantage of the advantages offered by the explosion of endoscopic surgery in recent years, simulation based training should be fully integrated and funded within training programmes for clinician at all stages. Simulation based training needs to be valued and adequately resourced by healthcare organisations. A skilled faculty of expert clinical facilitators should be developed to deliver high-quality simulation training. The importance of human factors training to safe care should be widely communicated.