Systems based on virtual reality (VR) for medical procedures simulation can provide realistic training of specific tasks, new techniques or new methods. The challenge of VR systems for medicine is to offer computer environments with features similar to the real world. Then, the systems should present realistic objects (shape, color, physical properties), explore the user senses and provide real-time response to the user interactions. In spite of the technological advances, high-level of realism can be associated to high-cost systems due the use of specific devices for interaction and visualization, the modeling and use of 3D models with physical properties, etc. Besides, only recently on-line methods to assess the user performance were proposed. Besides the cost, other difficulty related to the development of VR based simulators is the necessity of previous knowledge of the several programming tools related to each device and the methods used to provide visual, haptic and auditory responses. Additionally, all the tasks must be integrated and synchronized, and the real-time performance must be guaranteed.