Part two: medical simulation: how to build a successful and long-lasting program.

Background: This manuscript is part-two of a three-part series on Medical Simulation. Part-one addressed the 'why' of Simulation, namely, why Medical Simulation offers novel opportunities to improve education, continuing-competency, and patient safety. Part-two focuses on the 'how' of simulation, namely, how to design, implement, and maintain a viable pro-gram. Part-three will cover the 'what', namely what the future directions are likely to be, what sort of pro-grams are currently available, and what evidence sup-ports their implementation.Definitions: Our definition of 'Medical Simulation' means any technique, 'low-tech' or 'high tech', that attempts to realistically recreate clinical situations and allow training with minimum patient risk. In this way it resembles the 'war-games' of the military or 'flight simulators' of aviation. Medical training has always involved graduated acceptance of decision-making and supervised practice. Equally, examinations have long included actors. As such, medical training has always incorporated a degree of simulation of real practice. What has changed is the explosion of avail-able technology; the principles of adult education, the focus on patient safety, and the expectation of proof via research. Simulation is therefore a huge topic. We hope to offer a concise introduction. [ABSTRACT FROM AUTHOR]