PURPOSE: The objective of this survey was to explore Canadian anesthesiology residents' educational experience with high-fidelity simulation and to improve understanding of the factors perceived to have either a positive or a negative effect on residents' learning. METHODS: In 2008, all Canadian anesthesiology residents (n = 599) were invited to complete a ten-minute anonymous online survey. Survey questions were derived from two sources, a literature search of MEDLINE (1966 to present), EMBASE (1980 to present), and the Cochrane and Campbell collaboration libraries and the experience of 25 pilot residents and the lead author. RESULTS: The survey response rate was 27.9% (n = 167). Junior residents (PGY1-3) responded that it would be helpful to have an introductory simulation course dealing with common intraoperative emergencies. The introduction of multidisciplinary scenarios (where nurses and colleagues from different specialties were involved in scenarios) was strongly supported. With respect to gender, male anesthesia residents indicated their comfort in making mistakes and asking for help in the simulator more frequently than female residents. In accordance with the ten Best Evidence Medical Education (BEME) principles of successful simulator education, Canadian centres could improve residents' opportunities for repetitive practice (with feedback), individualization of scenarios, and defined learning outcomes for scenarios. DISCUSSION: Anesthesiology residents indicate that simulation-based education is an anxiety provoking experience, but value its role in promoting safe practice and enhancing one's ability to deal with emergency situations. Suggestions to improve simulation training include increasing residents' access, adopting a more student-centred approach to learning, and creating a safer learning environment.
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