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Objective: The Coronavirus disease-2019 (COVID-19) outbreak has deprived simulation-based medical education for health care workers. Attendees are strictly prohibited to converge at a simulation training venue because of the COVID-19 outbreaks. To address this issue, we developed a web-conference-style remote simulation program using demonstration video clips. This report introduced the method and described participants’ satisfaction. Methods: This preliminary survey study evaluated learners’ satisfaction in multiple institutions. The Satisfaction Scale Questionnaire with High-Fidelity Clinical Simulation (SSHF) by a 5-degree scale was used to evaluate participants’ satisfaction. The survey was conducted immediately after completing the simulation sessions. Results: Ten (100%) participants (7 anaesthesia individuals, 2 anaesthesia residents and 1 nurse anaesthetist) from nine institutions responded to the survey. All median values of the satisfaction scores were ≥4.0, whereas the median values of scores for environmental fidelity and psychological insecurity were 3.5 and 3.0, respectively ( P =0.005). Conclusion: A web-conference-style remote simulation using demonstration video clips is a feasible method for conducting simulation-based medical education under COVID-19 that showed high satisfaction scores. Further, additional studies are required to explore the internal and external validity and the effectiveness of mastery learning.

Pregnancy-related Group A streptococcus (GAS) sepsis is a rare, rapidly progressing life-threatening disease. Previous reports described the clinical features of pregnancy-related GAS sepsis, however, the evidence regarding general anesthesia is extremely limited. This report aims to alert anesthesiologists that pregnancy-related GAS sepsis is an emerging life-threatening disease and to describe the clinical issues when performing general anesthesia in the emergency cesarian section. We describe the case of a 37-year-old pregnant woman with undiagnosed pregnancy-related GAS sepsis who exhibited rapid, progressive circulatory collapse. Attentive anesthesia management and smooth transition to the cesarean section resulted in saving both the mother and baby without any complications. The evidence regarding anesthesia management in pregnancy-related GAS sepsis is extremely lacking. To make the diagnosis of GAS sepsis before initiating the emergency cesarean section was challenging under rapid deterioration. Anesthesiologists should consider GAS sepsis in pregnancy with aggressive septic features and prepare for the fatal intraoperative complications during general anesthesia.