Role of health simulation centres in the COVID-19 pandemic response in Italy: a national study

Introduction The COVID-19 pandemic has dramatically affected the Italian health systems and drastically impacted healthcare workers' daily routine and training. Simulation is an efficient tool to provide medical education, especially in the case of incoming public health emergencies. This study investigated the role and activities of Italian simulation centres (SCs) during the acute phase of the COVID-19 pandemic.Methods The population was identified through a web search. The directors of Italian SCs were contacted via email and then enrolled. A structured interview was created, internally validated and administrated by phone to participants.Results Following the government's ordinance, 37 (88.37%) SCs had to be closed to the public. Twenty (46.51%) SCs organised in situ simulation while 7 (16.28%) of them organised simulation inside the centre. Twenty-three (53.49%) SCs resorted to telematic modalities to provide training about COVID-19 and 21 (48.84%) of them for other training. Up to date, 13 SCs are still closed to the public.Conclusions Italy has been severely hit by COVID-19, with differences between the regions. Almost all the SCs were closed, with only a few delivering training. The SCs took advantage of emergent technologies to create new ways to train people safely. Unfortunately, nearly onefourth of Italian SCs have not reopened yet. The evolution of the COVID-19 epidemic calls for reconsideration about training activities including adequate safety measures implemented for all individuals involved.