The Mako Rio surgical robot was created to provide robotic assistance and computer-assisted planning to orthopedic surgeons performing hip and knee replacement procedures. Training to use this device is conducted in traditional face-to-face, instructor-led courses with the real robotic system on synthetic and cadaveric tissue. This form of training is expensive to produce and does not support reinforcement or repeated learning for the surgeon. This paper describes the analysis and design process for a simulator device that can supplement the current training methodology and allow for surgeon-initiated refreshment and repetitive training. The design process identified two different avenues for advancement in this field. First, existing surgical simulators were analyzed for technologies and capabilities that could be applied to a simulator for the Mako Rio. This included the capabilities of the hardware in 3D vision, 3D manipulation, and system operations; as well as the functionality of the software in VR exercises, validated scoring and metrics, system administration, student record management, and data export and reporting. This analysis identified two existing simulators that are viable platforms from which to create a Mako simulator – the Mimic dV-Trainer and the OSSIM coupled with a 3D vision system. Second, the study identified a much broader set of training needs surrounding all of robotic surgery education. All current simulators focus on basic surgical skills or surgical procedural skills. However modern immersive VR systems with haptic controls can provide a platform for simulation-based training that includes robotic mechanical control, surgical procedure planning, patient imagery analysis and selection, OR equipment and human patient placement, instrument table layout, and recovery from complications. None of these scenarios are available in any simulator device, though modern simulator systems have the capability to represent all of them. The results of this study indicate that medical and surgical simulator manufacturers and educators need to broaden the scope of the services offered to surgical educators.