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European simulation-based education and training in anaesthesiology and intensive care : evidence, value and inevitable evolution

2026-01-01T00:00:00Z

Title: European simulation-based education and training in anaesthesiology and intensive care : evidence, value and inevitable evolution Authors: Burlacu, Crina L.; Sinai, Yitzhak Brzezinski; Norte, Gustavo; Buléon, Clément; Štourač, Petr; Savoldelli, Georges L.; Berger-Estilita, Joana; Camilleri Podestà, Anne Marie; Østergaard, Doris Abstract: Anaesthesiologists, intensive care, and perioperative physicians work within multidisciplinary teams in high-risk environments where adverse events may threaten patient safety and are often avoidable. They face converging challenges, including multimorbidity and increasing clinical complexity, workforce shortages and burnout, technological evolution, and rising expectations for safety, equity, and sustainability. In this expert-driven evidence-based consensus review, we aim to demonstrate that simulation-based education and training (SBET) is uniquely positioned to address these challenges. We review how SBET adds value across the professional lifespan, from initial training to high-stakes examinations and continuing professional development. We further examine how SBET enhances team performance, identifies latent system threats, and supports organisational redesign through translational simulation. We examine how SBET can prepare for the future by fostering digital and ecological competencies. We explore key barriers to implementation, as despite SBET's value, its adoption across anaesthesiology, intensive care, and perioperative medicine remains fragmented, with limited interprofessional integration and few national frameworks. Above all, we advocate for coordinated value-based adoption of SBET across education and healthcare systems, recognising it not merely as an educational method but as a strategic infrastructure for high-reliability healthcare systems. Sustained investment, protected time, faculty development, and interprofessional integration are essential to realise its full potential. Aligned strategies to close the gap between evidence and practice are crucial. Without decisive and collective action, education and healthcare risk losing one of the most effective tools for improving patient safety, enhancing individual and system resilience, and maintaining the highest standards of excellence across our specialty and interprofessional practice.

ESAIC Mellin-Olsen declaration on diversity, equity and inclusion

2025-01-01T00:00:00Z

Title: ESAIC Mellin-Olsen declaration on diversity, equity and inclusion Authors: Gisselbaek, Mia; Saxena, Sarah; Berger-Estilita, Joana; Ateleanu, Bazil; Brazzi, Luca; Buhre, Wolfgang; Crisan, Iulia; Camilleri Podestà, Anne Marie; Coburn, Mark; Durnev, Vesna; Filipescu, Daniela; Ghezel-Ahmadi, David; Golubovska, Iveta; Arévalo, Emilia Guasch; Honorato-Cia, Cristina; Klimek, Markus; Meco, Basak Ceyda; Myatra, Sheila N.; Nahtomi-Shick, Orit; Neskovic, Vojislava; O’Sullivan, Ellen; Rubulotta, Francesca; Romero, Carolina; Sabelnikovs, Olegs; Struys, Michel MRF; Südy, Roberta; Weynant, Cathy; Ringvold, Else-Marie; Matot, Idit Abstract: Diversity, Equity and Inclusion (DEI) are not merely a matter of fairness and justice; these values are essential for fostering a dynamic, innovative and collaborative professional community. The United Nations and the European Commission emphasise the need for plans to increase diversity and sex equity. It is crucial to distinguish equality and equity: equality provides the same resources and opportunities to all, while equity tailors opportunities based on individual needs and circumstances. [excerpt]

Building resilience in perioperative medicine : ensuring safe care for all : a white paper from the European society of anaesthesiology and intensive care (ESAIC)

2026-01-01T00:00:00Z

Title: Building resilience in perioperative medicine : ensuring safe care for all : a white paper from the European society of anaesthesiology and intensive care (ESAIC) Authors: Buhre, Wolfgang; Struys, Michel; Klimek, Markus; de Robertis, Edoardo; Ringvold, Else-Marie; Camilleri Podestà, Anne Marie; Weynants, Cathy; Matot, Idit Abstract: European health systems are facing significant challenges. The COVID-19 pandemic added strain to an already struggling workforce and revealed weaknesses in the supply chain for essential medicines and technical devices. This situation has focused politicians on the need to develop resilient health systems that can prevent, prepare for, and recover from public health threats and crises, while also guaranteeing the continuous delivery of high-quality care for all citizens. Anaesthesiologists significantly contribute to healthcare resilience. They are involved in the care of 60% of patients in hospitals – the most holistic speciality in modern medical practice. They are the guardians of patient safety across all phases of perioperative care; from the moment a person contemplates a surgical or interventional procedure, following them through hospital admission until full recovery even after hospital discharge. They also play a key role in trauma care, obstetrics, intensive care, and pain management. And yet their contribution to medical practice is not sufficiently recognised or reflected within EU policy. This White Paper examines the challenges faced by the anaesthesiology profession and sets out recommendations to EU, national and local policymakers to ensure anaesthesiology plays its part in more resilient, high-quality health systems. Priority actions are required in three main areas: improving working conditions and training across all Member States; protecting the delivery of high-quality, person-centred care; and ensuring a sustainable healthcare environment is maintained across all aspects of perioperative care whilst always striving to the highest standards of patient safety. EU institutions should seize the opportunity to work closely with ESAIC and other relevant stakeholders to strengthen patient safety and perioperative care as a priority. They must proactively involve anaesthesiologists in any discussion that can have an impact on the profession and/or the hospital environment they work in. It is only by working together with all relevant stakeholders that we can make our health systems future proof to deliver safe, high-quality, sustainable and resilient care for all European citizens.

Consequences of a toxic workplace environment on psychological safety in anaesthesia and intensive care : a European survey

2026-01-01T00:00:00Z

Title: Consequences of a toxic workplace environment on psychological safety in anaesthesia and intensive care : a European survey Authors: Crisan, Iulia; Südy, Roberta; Gisselbaek, Mia; Abramovich, Igor; Hockenhull, Ben; Borisova, Donika; Karras, Georgios; Marty, Adrian P.; Camilleri Podestà, Anne Marie; Ringvold, Else-Marie; Berger-Estilita, Joana; Saxena, Sarah Abstract: BACKGROUND Toxic workplace environments in healthcare, characterised by discrimination, bullying, poor communication, and lack of support, have a negative effect on physicians’ well-being and patient safety. Anaesthesiologists and intensivists are at high risk of burnout due to the intensity of their work. However, the prevalence and consequences of a toxic work environment in these specialties across Europe remain unknown.; OBJECTIVES The primary objective of this study was to evaluate psychological safety among European anaesthesiologists and intensivists and its relationship to toxic workplace environments. The secondary objectives were to explore associated sociodemographic and professional factors, perceived support and job satisfaction, the prevalence and consequences of toxic workplace experiences, and the coping strategies used in response to them.; DESIGN Cross-sectional, multinational survey study.; SETTING Online anonymous survey distributed via the European Society of Anaesthesiology and Intensive Care mailing list and social media platforms between April and June 2025.; PARTICIPANTS Some 859 respondents: 491 women (57.2%), 364 men (42.4%) and 2 gender-fluid (0.2%). They were predominantly White European (87.2%). Most participants worked in academic hospitals, mainly in anaesthesia alone (80.6%).; INTERVENTIONS None.; MAIN OUTCOME MEASURES Psychological safety (Edmondson's 7-item scale), support/satisfaction (4-item scale), prevalence and consequences of toxic workplace experiences, and coping strategies.; RESULTS The Psychological Safety Scale showed high reliability (α = 0.85); the mean score was 4.12 ± 1.21. Burnout was reported by >50% of respondents and associated with significantly lower psychological safety and support/satisfaction scores (P < 0.001). Poor communication (59.6%) and poor leadership (45.9%) were the leading causes of perceived toxicity. Thirty-five percent reported health problems, 17% considered changing specialty, and 14% effectively changed workplace. Coping strategies were mainly adaptive, though 7.9% reported self-medication.; CONCLUSIONS Toxic workplace environments are prevalent in European anaesthesiology and intensive care, strongly associated with burnout and adverse health outcomes. Organisational reforms targeting leadership, communication, and psychological safety are urgently needed.