Simulation in Intensive Care Exams

Simulation-based education and evaluation of French medical students is still heterogeneous. To date, the use of simulation is not recommended for the tests required to obtain the certification in critical care medicine (CCM) in France. In response to a growing public demand for a safer healthcare system, teachers and medical societies have to guarantee that physicians are competent and able to provide optimal care to patients. Traditional assessment methods as multiple-choice exams or continuing medical education exercises may not be appro- priate to evaluate all competencies required for excellence in medical practice. Simulation provides relevant tools for assessing specific skills, not tested by other methods. Incor- poration of simulation in the tests required to obtain the cer- tification in CCM may improve their validity and provide a better guarantee of healthcare quality to the society. The main methods of medical simulation are standardized patients, mannequins and virtual reality. The simplest tech- niques are strongly validated to accurately and easily eva- luate small groups of students. These methods would be appropriate for local or interregional examinations. Due to their low cost, high validity and great reproducibility, stan- dardized patients, low-fidelity mannequins, multiple-choice questions and script concordance tests should be used as first-line options. The role of more complicated techniques as high-fidelity mannequins and complex virtual reality is still to be determined. We suggest that after a first step of evaluation, simulation methods may be part of the future validation tests for the certification in CCM in France.