Table 1.

Summary of initiative from aviation that have been replicated in surgical training

Description (level of barrier)	Airline industry	Healthcare system	Approximate delay to initiation (years)
Policy writing training (level 1)	The first checklist 1920	The WHO checklist 2008 [12]	88
Standardisation and simplification (level 2)	The first pilot license 1927	The first validated curriculum 2015 [13]	88
Simulation (level 2) (VR simulation level 3)	The first flight simulator 1920	The first VR simulation system 1993 [5]	73
Automation (level 3)	The first Black box 1953	VR simulation 1993 [5] Automated performance metrics [14] OR Black box 2018 [15]	65
Better devices and architecture (level 4)	The first control tower 1920	The first telementoring service 2001 [16]	81