Perioperative Simulation-based Medical Education in China: A Nationwide Cross- sectional Survey

Abstract Background: Simulation-based medical education (SBME) has rapidly emerged as a new trend in perioperative medical education in China. However, our understanding of its role and impact on medical education remains unclear. This study surveyed medical educators to assess SBME from the perspectives of administrators, instructors, and learners, identifying both its advantages and shortcomings. Methods: A cross-sectional online survey was conducted in 2024, involving administrators, instructors, and learners from medical education institutes across China. The survey included a structured questionnaire focused on perioperative SBME with information regarding participant characteristics, their attitudes, and perceived teaching obstacles. Descriptive statistics were used to summarize the current status of perioperative SBME, and logistic regression analysis helped identify factors potentially affecting learners' satisfaction with the program. Results: A total of 1411 survey respondents, including 274 administrative staff, 285 course instructors, 681 learners, and 250 others, participated in our study. Among administrators, 81.8% believed that SBME was crucial for perioperative medical training, emphasizing its role in enhancing trainees’ clinical skills and decision-making abilities. Key challenges identified by administrators and instructors included insufficient training space, simulation models, and faculty. Administrators advocated for increased investment in simulation resources (88.7%) and faculty development (84.3%). Instructors stressed the importance of enhanced faculty training (92.6%), implementing standardized training protocols (69.1%), and increasing the proportion of simulation-based teaching (68.1%). Learners recommended optimizing teaching schedules (65.9%) and improving simulation methods (64.2%). Notably, SBME implementation varied across different regions in China, especially in tertiary hospitals, where medical institutes in Southern and Eastern China run more SBME programs. Conclusions: SBME development has progressed in China, but faces imbalances across different regions and institutions. Furthermore, the availability of qualified instructors, equipment, and financial investment still need to be addressed. This study provides a foundation for the continued advancement of SBME.