title: Barriers to use of simulation-based education.
abstract: OBJECTIVE
  Barriers to simulation-based education in postgraduate and continuing education for anesthesiologists have not been well studied. We hypothesized that the level of training may influence attitudes towards simulation-based education and impact on the use of simulation. This study investigated this issue at the University of Toronto which possesses two sites equipped with high-fidelity patient simulators.
  
  
  METHODS
  A 40-question survey of experiences, perceptions, motivations and perceived barriers to simulation-based education, was distributed to 154 anesthesiologists attending a departmental conference. Data were analyzed using descriptive statistics and associations between responses were assessed using either the Chi-Square statistic or a one-way analysis of variance.
  
  
  RESULTS
  The rate of response was 58%. Residents had experienced simulation-based education (96%) more often than staff (58%) and fellows (36%), (P < 0.001 respectively). Residents had also attended more simulation sessions than staff and fellows (mean 2.8 vs 1.05 and 1.04, P < 0.001 respectively). Residents and fellows found simulation-based education more relevant for their training than staff (88% vs 65%, P < 0.05). Eighty-one percent of the respondents identified at least one significant barrier that prevents or limits them from attending simulator sessions. Staff anesthesiologists perceived multiple barriers and identified 'time' and 'financial issues' as significant barriers.
  
  
  CONCLUSIONS
  Anesthesiologists' level of training influences their attitudes towards and their perceptions of simulation-based education. This survey has identified perceived barriers that may limit a wider utilization of simulation. These results may be used to implement targeted actions such as course design, incentives, and information strategies, which could improve access and future use of simulation.
authors.affiliation: Wilson Center for Research in Education Faculty of Medicine, Toronto, Ontario, Canada. georges.savoldelli@utoronto.ca
authors.forename: Georges L
authors.initials: GL
authors.lastname: Savoldelli
authors.forename: Viren N
authors.initials: VN
authors.lastname: Naik
authors.forename: Stanley J
authors.initials: SJ
authors.lastname: Hamstra
authors.forename: Pamela J
authors.initials: PJ
authors.lastname: Morgan
mesh_terms: D000776:Anesthesiology / Q000193:education*; D001291:Attitude of Health Personnel; D002170:Canada; D003625:Data Collection; D004502:Education, Medical, Continuing; D006801:Humans; D007396:Internship and Residency; D009042:Motivation; D016544:Patient Simulation; D011795:Surveys and Questionnaires