Delivery of ultrasound training remains a challenge. This thesis presents a series of projects that investigated a new approach in acquiring transvaginal ultrasound skills (TVS) in obstetrics and gynaecology using a novel virtual reality simulator (ScanTrainer®, Medaphor plc, Cardiff, Wales). Aims and objectives:(1) To evaluate the validity and reliability of the simulator,(2)to assess the learning curves of trainees’ competence in performing TVS, and (3) to define potential benefits and limitations of simulation training from the trainee’s perspective. These were achieved by undertaking the following studies (1) face, content and construct validity of the simulator, (2) reliability of scoring systems developed for the assessment of ultrasound in obstetrics and gynaecology, (3) validation of simulation scoring system against experts, and (4) evaluating the role of simulation on TVUS skill acquisition (learning curve) in the clinical training environment. Methods: The projects included observational, comparative and semi-qualitative studies and randomised controlled trial (RCT) comparing conventional with simulation supported training. Results: (1) Face and content validity study demonstrated high acceptability of the simulator. (2) Construct validity study showed significant differences between inovices and experts’ performances, p < 0.05. (3) Validation studies showed excellent agreement (i) between two observers in assessing simulated TVUS performances and(ii) between the observer and the simulator scoring system (intra-class correlation coefficient > 0.75). (4) In the RCT, the overall analysis according to the randomisation arm showed no statistically significant difference between the intervention and control groups. (5) Fifty-seven percent of trainees agreed that simulation was a flexible learning platform in practicing TVUS as an adjunct to clinical training. Conclusion: The ScanTrainer® simulator has high face, content and constructs' validity that support the research hypotheses. It also has a potential role in the assessment of clinical skills. However, the impact of simulation on the learning curves requires further evaluation.