CoSMEU group (Italian Society of Emergency Medicine Residents): Cascio Michela, Ceschi Ludovica, Di Cristoforo Monica, La Spina Letizia, Malacarne Cecilia, Pons Sofia, Silvestri Giulia.   Emergency Medicine (EM) is a novel specialty in Italy. It exists only since 2009, and CoSMEU (Coordinamento Specializzandi Medicina d’Emergenza-Urgenza) is the national association of EM residents. On behalf of CoSMEU, we conducted an electronic survey open to all the Italian EM residents, with the aim to assess their awareness about the acquisition of technical skills and clinical knowledge during the academic year 2019-2020. Out of 1666 EM residents, 434 (26%) responded to the survey, in representation of all the 33 medical school programs. For 63.6% of them EM was their first-choice program. A high percentage of EM residents have denounced a lack of education and hands-on opportunities to fully complete their training as planned, in the absence of simulation and certifications, and with not-standardized educational programs across the EM schools. Although the Italian EM and specialty are currently facing a crisis, all the EM residents are working hard to support EM system optimization.

Dear Editor, As part of the board of CoSMEU – the Italian association of Emergency Medicine (EM) residents – we are looking with great concern at the current situation of the Emergency Departments (ED) and EM in our country,1 and we would like to share our point of view and experience. [...]

Background Simulation is an educational tool widely used worldwide and simulation-based education is an important training strategy in Emergency Medicine (EM) training programs. Objective In the first part of the project SIMinMEU of CosMEU and SIMMED, an electronic survey open to the Italian EM residents’ representatives was created with the aim to assess their awareness about simulation in their programs. Results Out of 33 EM residencies, 30 representatives answered the survey. Only 15 schools offer simulation, with a median of 16,27 (range 0–46) annual simulation training, with 53% of representatives indicating that the time dedicated to it met their needs. 15 do skill lab activities (50 %), 14 do High fidelity simulation (46.66%), one does serious games (3,33%) and one does virtual reality (3,33%). In situ simulations aren’t provided. Crisis resource management (CRM) and soft skills are topics covered in seven (23,3%). In 5 residencies (16,6%) there are certified facilitators. The annual exams aren’t carried out using simulation. Only in five (16,6%) residencies research in simulation is carried out. Residents’ satisfaction for simulation activities is lower than good in 73% of cases. Most residents stated lack of simulation standards and poor quality of simulation activities. The main requests are that simulation must be part of the teaching program, increased in number and better structured. Conclusions Considering the increasing interest of residents in simulation emerged by this survey, CoSMEU and SIMMED will commit to improving the quality, facilitating the spreading and guaranteeing the standardization of simulation in every EM Italian school.