he ASA Committee on Simulation Education was constituted at the 2006 Annual Meeting to foster ASA members’ access to high-quality simulation-based continuing medical education (CME). To accomplish this mission, the committee intends to identify, evaluate and endorse simulation programs nationwide. The endorsement process is designed to identify programs that have the necessary expertise, facilities and equipment to offer simulation-based CME that is valued by ASA membership.

Applications from simulation programs seeking the designation of “ASA-Endorsed Program” are now being accepted at the ASA Simulation Web site www.ASAhq.org/SIM. The application is structured to mirror the intent and content developed by the committee’s predecessor, the Workgroup on Simulation Education, and is described in the workgroup’s white paper “ASA Approval of Anesthesiology Simulation Programs.” Applicants are encouraged to read this document, which is posted on the ASA simulation Web site, prior to completing the application.

A variety of factors will be considered when evaluating an application for endorsement. In particular, those attributes that ASA believes are important to the simulation program are:

• Existing educational offerings

• Experience and track record

• Process of curriculum development

• Process of instructor and course evaluation

• Leadership

• Infrastructure to support CME

• Policies and procedures to address issues such as performance anxiety and confidentiality.

The advantages of this simulation-based CME program to ASA members include experiential training from peer-reviewed programs, an opportunity to improve patient safety through teamwork and critical event training, and a chance to reflect on management of challenging situations in a confidential setting. In addition to CME credit, in the future, ASA members will be able to receive credit from the American Board of Anesthesiology (ABA) toward the Maintenance of Certification in Anesthesiology in the category of Practice Performance Assessment and Improvement. ABA Diplomates with time-limited certification are required to participate in a certification program every 10 years in order to maintain their certification. In the near future, diplomates will be expected to participate in simulation-based CME as part of MOCA. The simulation requirement will be a unique educational experience, not a test, with a design that will minimize the potentially intimidating nature of simulation-based education.

In a survey of ASA members conducted in 2005, 81 percent of the 1,400 ASA member respondents were interested in simulation-based CME. Interestingly, nearly as many (71 percent) desired an assessment of their performance. Types of courses favored included scenarios involving infrequent, difficult situations (89 percent), emergency airway techniques (80 percent), crisis resource management (79 percent) and team training (64 percent).

Advantages to simulation programs include endorsement by peers and ASA along with increased visibility to ASA members seeking CME. Additionally, endorsed programs benefit from a collaborative network of simulation resources. The committee plans to develop a library of scenarios, which will be available to endorsed programs, and to encourage content sharing among programs. As part of the application process, a program must submit a sample simulation scenario appropriate for the training of ASA members. At the discretion of the committee, scenarios from endorsed programs will become part of the shared library.

Courses offered to ASA members by endorsed programs must include at least one scenario from the ASA library (programs may use their own submission if desired). Moreover, these courses will use an ASA committee-approved standard course evaluation form, which may be supplemented by program-specific questions. The use of standardized content will one day permit performance assessment across centers and foster evidence-based curricula.

Endorsed programs will be expected to participate in the ongoing development and improvement of the educational offerings available to ASA members. Endorsed programs will receive comparative data about the evaluation of their ASA course versus those of other endorsed programs as well as information about the effectiveness of course content and directions for future course content. Endorsements will be limited to two years. Programs seeking renewal of endorsed status will be required to meet criteria in force at the time of renewal.

The committee’s decision regarding approval or deferral of a program’s endorsement will be based upon whether minimal criteria are met. Programs must be able to award CME credit to participants. Programs may submit applications to ASA while establishing their status as a CME provider through their local institution, but ASA endorsement status will not be conferred until applicants provide documentation of CME provider status. Selected applicants will undergo site reviews, after which the first endorsed programs will be announced in spring 2008.

To stimulate the development of a network of qualified programs, ABA is offering a time-limited rebate for the ASA program endorsement application fee. Successfully endorsed programs will receive a 75 percent rebate of the ASA program application fee if endorsed by the ASA Committee on Simulation Education prior to December 31, 2008.

Please see the ASA Simulation Web site www.ASAhq.org/SIM for the latest information, including updated information for prospective applicants and for ASA members interested in simulation-based CME.

Randolph H. Steadman, M.D., is Professor and Vice-Chair, Department of Anesthesiology, David Geffen School of Medicine at the University of California Los Angeles.