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Medical simulation-based teaching includes a variety of educational techniques used to complement actual patient experiences with true-to-life yet artificial tasks. This field is rapidly growing and is widely used in critical care graduate medical education programs, having teaching, learning and assessment roles. Its use is on the increase due to many factors including patient discontent with being “practiced on”, current considerations regarding patient safety, and the significance of early attainment of complex medical proficiencies. Simulation-based assessment (SBA) is advancing to the point where it can revolutionize the way clinical competence is assessed in residency training programs. A whole new professional vocabulary has developed in tandem with this type of teaching. We refer to “learning environments”, “regulatory expectations”, “micro and macro simulators”, “quality control”, “teaching tools” and” time courses” [1,2]. Learning and acquiring clinical skills by simulator-based training is very much an educational tool still under scrutiny. A recent survey indicated that Canadian anaesthesiology residents reported that they were intimidated by the atmosphere of high fidelity simulator-based educational methods but valued it as a means of promoting safe practice and developing skills required in emergency situations [3]. Nevertheless, due to the practical impossibility of students to encounter and manage every important critical experience and scenario essential for the completion of a comprehensive medical training, simulatorbased educational centres fill this gap. Simulator-based sessions are highly appreciated by medical students, as shown in a recent study analysing the degree of satisfaction of the students undertaking such courses in the University of Tirgu-Mures [4]. Medical conditions such as SARS (Severe Acute Respiratory Syndrome), a worrying condition associated with a high mortality, are now relatively common. High fidelity simulator-based educational programmes have been developed and have led to the implementation of an adapted cardiac arrest protocol for use in SARS. This proved to be crucial in the subsequent teaching of trainees in the use of unfamiliar protective equipment [6]. Simulator-based programs were successfully used to teach chest tube insertion. On completion of simulatorbased training, those surgeons trained by this method were compared with doctors who had not be trained by this approach, and it was found that simulator-based taught surgeons exhibited more self-confidence and satisfaction than those taught in a more conventional manner [7]. This issue of the Journal of Critical Care Medicine (JCCM) hosts an article on the perception of residents in anaesthesia and intensive care in four of the medical education centres in Romania, The Universities of Medicine in Cluj, Tirgu Mures, Iasi and Bucharest regarding simulator-based training [8]. Training in anaesthesia and intensive care comprises five years of study and concomitant practice. Submitting patients to the stress of demonstrating, learning and conducting medical and surgical procedures by junior doctors is not without an increased risk to these patients. This is why, despite the fact that simulator-based teaching centres are resource consuming, their introduction into the medical curriculum, is well worth the financial outlay.

Simulation-based Training as Perceived by Young Anesthesiology and Intensive Care Residents