Simulation lets you do stuff that you couldn't otherwise do. In no way does it replace the real thing (and experience/practice with the real thing)
Codes (and ACLS certification) in sim labs are no where close to the real thing but it's the closest you can get. Repetition, and a couple real experience under your belt - and if you are suddenly the code leader at a real code, you won't freeze - you'll know automatically what to do (hopefully).
Central lines simulation are good at knowing the steps and techniques - it is no where close to the real thing (eg., no beating carotid and moving patients for jugular, no morbidly obese simulation for subclavian or femoral, etc) - but at least you can practice identifying landmarks, and if you have ultrasound, practice needle placement in real time with ultrasound
The laproscopic 3D simulation is good at improving hand-eye coordination
As a fellow, the bronchoscopy simulator was helpful in getting used to the bronchoscope and how to drive it down various airways - as well as learning the various airways which is very important to a bronchoscopist. I could also practice invasive procedures (ie transbronchial biopsy, endobronchial biopsy, EBUS and identification of lymph nodes and TBNA, etc) without worry about the "patient" and excessive bleeding, pneumothorax, hypoxia, excessive endoscopy staff or anesthesia staff time, etc
I can see them useful for fellows, residents, and even attendings who want to learn new tricks and techniques. For 1st and 2nd year students - not so much (practicing IV placement on a simulated arm before a real person would be helpful, practicing ABG on a simulated forearm instead of a real patient could be useful). I can see it useful for 3rd year and beyond.
But nothing beats the real thing. But to get the technique down and knowing landmarks before your first real patient encounter - it is useful
Just my opinion
