Introduction Simulation based training (SBT) has gained significant traction within Emergency-Medicine (EM). The growing body of evidence describes the benefits that SBT can bring. However, identifying barriers and enablers when establishing successful SBT programmes in busy Emergency Departments (ED’s), and ensuring longevity of such programs, can be difficult.[MJ1]

Objective We aim to identify barriers and enablers to Simulation based training in busy Eds.

Methods We explored and analysed the thoughts, experience, and opinions of professionals involved in simulation based training and organisational support. 32 participants across 15 international sites were invited to a semi-structured interview process. We included participants from a variety of backgrounds, from clinical staff to management staff. Transcribed interview data was classified and coded based on Capability, Opportunity, and Motivation (COM-B) domains and analysed based on Theoretical Domains Framework (TDF). Frequency of the most mentioned thematic domain among participants are reported.

Results The interview data revealed several common themes, including the following: knowledge and skills (90%), support and leadership (96%), mental barriers (87.5%), local culture (96.6%), dedicated space (65.2%), time constraints (46.8%), social influence (87.5%), education (90.6%), professional development (68.75%), exams (59.3%), and personal goals (93.75%). Management staff was observed to prioritise resource, staffing, and flow, while the clinical cohort tended to focus on specialty and personal development when it came to simulation training in the ED.

Conclusion Potential barriers and enablers to SBT and in-situ simulation for Emergency Departments were identified through interviews conducted in this study. The central themes in terms of barriers and enablers were local culture, leadership, individual needs, resources and optimisation. A tailored approach is vital for establishing a successful SBT and in situ simulation program.