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Simul Healthc. 2019 Apr 8. doi: 10.1097/SIH.0000000000000360. [Epub ahead of print]

Association of the Number of a Simulation Faculty With the Implementation of Simulation-Based Education.

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From the Department of Emergency and Critical Care Medicine (J.T., T.S., H.F., Y.H., M.M., Y.I.), Tokyo Bay Urayasu Ichikawa Medical Center; SAMURAI JADECOM Simulation Center (J.T., T.S., M.M.), Urayasu, Chiba; Department of Emergency Medicine (T.S.), International University of Health and Welfare, Minato, Tokyo; and Department of Emergency and Critical Care Medicine (H.H.), Yokosuka General Hospital Uwamachi, Kanagawa, Japan.



Although the implementation of simulation-based education (SBE) is essential for emergency medicine residency programs (EMRPs), little is known about the factors associated with its degree of SBE implementation in EMRPs. Therefore, this study aimed to investigate factors associated with SBE implementation in EMRPs. We hypothesized that the number of the simulation faculty was associated with the degree of SBE implementation.


We conducted a multicenter, cross-sectional survey on SBE implementation in emergency medicine resident education, in accredited EMRPs in the Greater Tokyo area, Japan. Survey question themes included institutional characteristics and the status of simulation education in them. For analyzing factors associated with SBE implementation, we defined EMRPs with a robust SBE implementation as those having an annual simulation time exceeding 10 hours.


The survey response rate was 73% (115/158). Of the EMRPs that responded, 32% reported that their annual simulation time was more than 10 hours. In the unadjusted analysis, possession of a simulator in the emergency department was significantly associated with nonrobust SBE implementation, but the number of the simulation faculty was significantly associated. On adjusting for possession of a simulator in the emergency department, presence of simulation curriculum, and presence of simulation-based formative or comprehensive assessment, we observed an association of robust SBE implementation with a number of the simulation faculty (unit odds ratio = 1.33; 95% confidence interval = 1.10-1.60).


To our knowledge, this is the first Japanese study to demonstrate that the number of the simulation faculty at a program is independently associated with a robust SBE implementation.

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