Simulation training in Canadian College of Family Physicians Emergency Medicine (CCFP-EM) programs

The Canadian College of Family Physicians Emergency Medicine (CCFP-EM) program offers 1 year of enhanced emergency training following a 2-year family medicine residency. Due to limited training time and unpredictable exposure to high-acuity scenarios, simulation-based education plays a critical role in developing procedural and crisis resource management competencies. This study aimed to characterize simulation use across Canadian CCFP-EM programs, with objectives to 1) describe the volume and delivery of simulation programs, 2) outline curricular content, and 3) explore how simulation is used for assessment.

From June 2023 to January 2024, we interviewed 16 out of 17 program representatives from Canadian CCFP-EM programs. Data were collected via both a pre-interview survey and a semi-structured interview. Program representatives included program directors, assistant program directors, or simulation directors.

All programs reported access to a simulation center, with 25% offering remote or virtual simulation. The median simulation hours provided across programs was 42 h annually, with individual residents participating 40 h on average. Most programs covered core national emergency medicine simulation topics, obtaining cases from their own case bank, or using open-access simulation resources. Most program representatives supported developing a standardized national simulation curriculum, emphasizing the need for flexibility for local adaptation. Only 31% of programs used simulation for assessment, citing concerns over psychological safety, feasibility and standardization. Faculty time and cost were the most cited barriers to simulation in general. Notable innovations included disaster simulations, resident-led peer teaching, and specialist-assisted procedural curriculum.

Our results provide a starting point for discussion and collaboration across programs, creating opportunities to optimize curricular development and the use of simulation for assessment, while considering resource availability and learner psychological safety. Simulation-based education has been a key educational tool, and educators and program leaders must understand how we are using simulation to teach our residents.