Simulation Resources in Emergency Medicine Residencies: A National Survey

The American Board of Emergency Medicine's new Certifying Exam features simulation-based assessment. The current resources available to prepare residents to pass this high-stakes exam are unknown. We sought to assess the current state of simulation resources and utilization in EM residency programs.

This was a cross-sectional survey study of residency or simulation leadership at ACGME-accredited EM programs. We developed an online survey consisting of multiple-choice items, which was piloted before use. We collected data from August to December 2024. We calculated descriptive statistics, used chi-squared testing for categorical data comparisons, and Kruskal-Wallis for ordinal variables. Univariate logistic regression was used to examine associations between EM residency and simulation resource factors with annual simulation training hours.

We identified contact information for 287 programs, and 194 completed the survey (67.6%). Most EM Residency programs had a simulation center (94.8%, 184/194). Fewer programs had simulation fellowship-trained physician faculty (44.3%, 86/194) or a division of simulation (40.7%, 79/194). Approximately 83% (161/194) of respondents felt that accessing simulation resources was easy or very easy. The median number of hours residents were engaged in simulation training per year was 40 (IQR 25-59). Univariate logistic regression found no association between EM program demographics and the annual number of hours of simulation training. The presence of simulation-trained faculty was associated with increased hours of simulation (OR 1.82, 95% CI 1.1-3.0, p = 0.05).

While most participating EM residency programs have access to simulation resources, variability exists in resources and implementation across programs, which may lead to inequities in preparing trainees for the new ABEM Certifying Exam.