Background: Simulation appears to be now an essential tool for the training of both technical and nontechnical medical skills. It allows to respect the ethical statement: "Never the first time on a real patient". Currently, integration of simulation in training programs is not harmonized between French medicine faculties. The corresponding framework remains to be defined in anticipation of the creation of the diploma of Emergency Medical Specialty (DES) planned for fall 2017. Objective: This investigation addressed the use of simulation in French initial formation in emergency medicine. It was intended as a first step toward establishing a simulation-based training program. Method: This observational study was multicentric. A questionnaire was sent by e-mail to all coordinators of Emergency Medicine initial formation in France. Data were compiled with Excel software (Microsoft Inc.). They included both quantitative and qualitative items that concerned the general context, the structure, and the content of the simulation-based training. Results: Twenty-five out of 29 universities answered the questionnaire. Among those, 23 (92%) used simulation, 22 of them used high-fidelity simulation, and 21 used procedural simulation. The most involved application fields were: cardiac arrest (22), shock state (21), chest pain, tachycardia (20), severe trauma and traumatic brain injury (17). The most practiced technical procedures were: intubation (22), difficult intubation (21), mechanical ventilation and intraosseous access (18). Median time was 2-3 days of simulation by year. In 12 centers (52%), the training staff had dedicated time duty and 15 centers (65%) benefited from remunerated staff. Finally, only 12 centers (52%) felt they essentially complied with the statement "Never the first time on a real patient". Discussion: Simulation use in French emergency physician's initial training is heterogeneous. The main limitation of our study was the absence of response from 4 faculties. Generally, responding coordinators agreed on the main situations and techniques to be taught. As in other countries, promotion of simulation seems to be consensual. However, effective deployment remains difficult due to material investment, formation and availability of staff. This study could provide a basis for the establishment of a national simulation-based training program.
