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Simulation based medical education is gaining wide spread appeal as a means to increase medical skill training opportunities and enhance patient safety in a changing medical environment. Two factors have accelerated the adoption of patient simulation in health care including; 1) the successful use of simulation in other high risk endeavors such as airline pilot training, and, 2) the high face validity of patient simulation. It is expected that the use of computerized manikins and patient simulation will continue to grow. Much research demonstrates the use and apparent effectiveness of simulation-based training. However, comparative evaluation of simulation-based training methods is needed to better understand how and when simulation based training can best be used to improve performance of medical skills. Furthermore, there is little evidence of the translational impact of simulation-based training for patient care related outcome measures. Current practice in patient simulation is discussed along with the use of an informatics framework which can guide the conduct of needed research to further develop simulation technology, and advance the use of simulation based technology for medical education.