The Østergaard Declaration: Simulation for Patient Safety

The publication of the Østergaard Declaration marks an important step in how we think about patient safety, recognising simulation as a strategic investment in safer patient care. As authors, our goal was to make a clear statement that simulation is no longer simply an educational technique – it is a patient safety intervention in its own right.

Every day, clinicians perform complex procedures, communicate under pressure, and manage life-threatening emergencies in an increasingly complex clinical environment characterised by an ageing population, increasing multimorbidity, workforce shortages, and rapid technological advancement. Patients should not bear the risks associated with acquiring or maintaining these skills. Instead, healthcare professionals should have regular opportunities to practise, refine, and challenge themselves in simulated environments. Central to this is psychological safety. Meaningful learning occurs when participants feel able to make mistakes, reflect openly, and receive constructive feedback without fear of judgement. Creating this culture of openness is fundamental not only to effective simulation but also to safer healthcare.

One of the Declaration’s strongest messages is that simulation is relevant throughout a clinician’s career. While simulation is well established in under- and postgraduate training, it is equally valuable for experienced practitioners. As careers evolve, simulation helps clinicians maintain competence, adapt to age-related changes, embrace new technologies and models of care, and navigate changing roles and responsibilities. It also promotes professional wellbeing by building confidence during periods of professional transition resulting from an increasingly mobile healthcare workforce. Simulation is therefore not simply a means of acquiring new skills but a lifelong resource that supports adaptation, resilience, and safe clinical practice.

Simulation also strengthens multidisciplinary teams. By practising together in realistic scenarios, teams improve communication, leadership, decision-making, situational awareness, and role clarity. It develops shared mental models, clarifies roles and responsibilities, improves situational awareness, and enhances the ability to anticipate and respond to evolving situations, while building the trust and psychological safety that underpin effective teamwork. The result is stronger individual and collective performance, leading to safer, more reliable patient care.

The Declaration further recognises that improving patient safety requires more than educating individuals and teams. Simulation is increasingly used to test new facilities, equipment, clinical pathways, and emergency responses before patients are exposed to them, allowing organisations to identify latent safety threats and strengthen the systems that support safe care. This reinforces an important principle: patient safety depends not only on competent professionals but also on resilient healthcare systems.

The Østergaard Declaration is not intended to be simply another position statement. It is a roadmap for implementation. The European Society of Anaesthesiology and Intensive Care is committed to supporting a European simulation curriculum across National Anaesthesiology Societies, aligning simulation with European Training Requirements, fostering collaboration and the sharing of educational resources, and training skilled simulation faculty who can sustain high-quality programmes.

Ultimately, the Østergaard Declaration calls on healthcare organisations, educators, and policymakers to provide sustainable funding, faculty development, research, and infrastructure for simulation because it contributes directly to safer care and improved outcomes. Simulation must be recognised as a strategic investment in patient safety.

The Østergaard Declaration and accompanying EJA Editorial are available on the ESAIC website.

Author: Prof. Crina L Burlacu, MD, MSc, FCARCSI, DEAA, FESAIC, ESAIC Chair Simulation Committee