The role of low- and high-fidelity simulations in training tomorrow’s neurovascular surgeons: a mini review based on the experience of King’s NeuroLab

Neurovascular surgical training has faced significant challenges due to declining operative caseloads, increasing procedural complexity, and evolving workforce constraints, including reduced working hours and heightened service demands. These pressures have reduced opportunities for neurovascular surgeons in training to gain consistent, high-quality operative exposure. Consequently, there is a growing need for innovative educational strategies to ensure that future neurosurgeons acquire both technical proficiency and sound clinical judgment. Simulation-based training has emerged as a key adjunct, offering a controlled, reproducible, and risk-free environment in which the surgeons of tomorrow can develop and refine both technical and non-technical skills. Advances in technology have enabled increasingly realistic models, from virtual reality platforms to high-fidelity physical simulators, enhancing the educational value of such interventions alongside more established training methods such as cadaveric training. We review the expanding role of simulation in neurovascular training and describe our experience in the King’s NeuroLab, where structured simulation modules are integrated into a broader training curriculum. Our experience demonstrates that simulation—while not a substitute for operative experience—can accelerate the learning curve, reduce technical errors, and enhance trainee confidence. Ultimately, simulation, when embedded within a comprehensive and competency-based curriculum, is essential for preparing the next generation of neurovascular surgeons to meet operative and patient safety demands.