The State of Simulation in Emergency Medicine Residency Programs in the United States

Using simulation-based medical education has proven to be an effective instructional strategy both procedurally and clinically. Emergency medicine (EM) residency programs use simulation in a variety of ways and settings. Given the ongoing development of the field and the recent expansion of EM training programs, our objective was to assess the current state of simulation use in Accreditation Council for Graduate Medical Education (ACGME)-approved EM residency programs in the United States.

We performed this cross-sectional national survey from July-September 2022. The survey was sent to the residency program directors of all 277 ACGME-accredited EM residency programs in the US. The survey focused on simulation use, technology, types of simulation (procedural vs case-based), barriers to growth, and overall sentiments regarding simulation in EM.

We attempted to contact 277 programs, successfully reaching 244. We received a total of 100 responses (36%). Nearly all responding programs reported access to a dedicated sim center (95.8%), with available high-fidelity manikin simulators (93%) and task trainers (90%). Most programs engage in simulation didactics monthly (50%), followed by more than monthly (22%) and quarterly (19%). Barriers to simulation implementation included funding, simulation lab availability, and equipment. Programs frequently used simulation to perform the majority of rare but required procedures, and about half of the programs responding reported simulation fellowship-trained faculty on staff.

Simulation education is an important aspect of EM residency and training. Most residency programs reported dedication and resources to developing and integrating simulation into their curriculum. There is likely room for its further use in residency program training in the coming years as residency programs continue to expand.