This volume explores the development process of a Virtual Reality (VR) and web-based medical training system from a user-centred perspective. It highlights the importance of user participation in this context by analysing two case studies concerned with the development of a VR and web-based medical training system for Spinal Anaesthesia. It illustrates the relationship between user participation and the development process of a VR and web-based medical training system. User groups, along with their input and degrees of participation and influence, are classified. It shows how a democratic arrangement between users and developers is beneficial and maybe even mandatory in order to utilise the users guidance efficiently. In this arrangement, the use of prototypes is instrumental in bridging the expertise and knowledge gap between users and developers. Reading this volume may aid other research teams developing VR and web-based medical training systems in deciding if, why and how to involve relevant user groups in the overall development process.