We report on a study that investigates the relationship between visual working memory and verbal working memory and a performance measure in endoscopic instrument navigation in MIST and GI Mentor II (a simulator for gastroendoscopy). Integrated cognitive neuroscience in state-of-the-art simulator training curriculum will take safety science in health care one step ahead. Current simulator validation focuses on how to train. In the light of recent research it is now prime time to ask why in search of mechanisms rather than to repeatedly show that training has effect. This will help tailor training to maximize individual output in procedures that require a high level of dexterity. WM training is a unique learning aid in simulator training and should be used alongside clinical practice in order to improve the quality of complex clinical intervention in the field of image guided surgical simulation.