Simulation: from task-trainer to Crisis Resource Management, a teaching challenge for emergency medicine

Medical practice includes theoretical knowledge, the know-how, and the "savoir-etre". Simulation can be beneficial in these three domains and represents a fantastic teaching tool for emergency medicine. Anesthetists were the pioneers in medical simulation. Simulation is a teaching technique, not a technology. It allows gain in individual competency by the use of task-trainers, up to the development of a team performance. It can be used either in initial or CME, and aims the understanding and the avoidance of human errors, which are responsible for the lack of performance. Emergency medicine offers a lot of possibilities for the use of task-trainers to train oneself to procedures, especially when they are rare ones, with a benefit of simulation over didactic teaching alone. The use of complex scenarios with high-fidelity mannequins can improve competencies, behaviors and individual interactions. Communication and teamwork are essential issues of the performance and crisis resource management. Simulation-based training should be assessed according to a approved process aiming to reach the measurement of clinical impact. The spreading of simulation is linked to the development of research measuring its clinical impact and multidisciplinary team training as well. Emergency departments should be among the first to benefit of this new teaching method. Ethics, technology and economy would be the winners.