Current state of simulation-based education and training in anaesthesiology and intensive care specialist residency programmes

BACKGROUND: Simulation-based education and training (SBET) is as an essential component of competency-based education in anaesthesiology and intensive care medicine endorsed by European training standards. Therefore, data on its formal integration into national residency curricula across Europe should be regularly updated. OBJECTIVES: To describe the current implementation and structure of SBET in anaesthesiology and intensive care residency programmes across countries affiliated with the European Society of Anaesthesiology and Intensive Care (ESAIC). DESIGN: International cross-sectional survey. SETTING: A pan-European survey conducted within the ESAIC framework between 22 January and 17 February 2026. PARTICIPANTS: Representatives of the National Anaesthesiologists Societies Committee (NASC) and ESAIC Simulation Ambassadors with responsibility for postgraduate education or simulation programmes. INTERVENTIONS: None. MAIN OUTCOME MEASURES: The primary objective of this study was to collect data on the prevalence of mandatory SBET programmes, training frequency, modalities and thematic content, funding mechanisms, integration into working hours, and the perceived barriers in countries without mandatory programmes. RESULTS: Forty-three responses from ESAIC member countries were analysed. Mandatory SBET within national curricula was reported in 19 (44.2%) countries, while 8 (18.6%) countries recommended SBET, and 16 (37.2%) reported no formal integration. Among countries with mandatory programmes, high-fidelity simulation was required in 16 of 19 (84.2%). The number of required simulation training days varied substantially between countries. Funding for mandatory SBET was mostly provided by employers (57.9%). Among countries without mandatory programmes, 17 of 24 (70.8%) reported plans to introduce mandatory SBET, often within the next five years. CONCLUSIONS: Substantial heterogeneity persists in the integration of SBET in European anaesthesiology and intensive care residency curricula. Although fewer than half of countries currently mandate SBET, many report plans to introduce such programmes in the future. These findings highlight both existing variability and the ongoing development of SBET within European anaesthesiology and intensive care training systems. TRIAL REGISTRATION: ClinicalTrials.gov ID: NCT07110012.