Flight training in full flight simulators (FFS) has been the standard in large fixed-wing aircraft for years. In the past, there were only a couple of helicopter simulators. These were mainly large twin-engine IFR helicopters like the Sikorsky S76 and Bell 430. Recently, simulator manufacturers have been introducing more helicopter devices and seeking certification at higher FFS levels (levels B, C and D with full motion capabilities).
Many operators and airframe manufacturers have already acquired low level non-motion FTDs (Flight Training Devices) to supplement flight training in the aircraft. With computer power and visual systems getting better and cheaper, higher level simulators are becoming more popular. Even for light single-engine helicopters operators are starting to embrace simulator training. Especially for FAA Part 135 operators who can complete required annual check-rides in a FFS.
During the next 5 to 10 years, more helicopter training will be done in simulators. Hopefully, this will lead to more frequent and comprehensive training that will help reduce the accident rate, especially for EMS operators.