We have read with pleasure the interesting article published in Medicina Intensiva, “Patient safety: what do clinical simulation and educational innovation contribute?”.1 The authors focus on the use of clinical simulation to enhance and improve patient safety, an issue with which we agree; however, we want to contribute that simulation currently, and in the future has in the undergraduate education of medical students.

The introduction of simulation mannequins served as a complement to medical education since 1960. In the United States and Canada, the Resusci Anne mannequin was implemented to teach mouth-to-mouth resuscitation and later evolved for the practice of cardiopulmonary resuscitation. Another mannequin, the SIM 1, was used in the 1960s for other educational purposes, as it included blinking eyes, pupils capable of changing size, a jaw that could open, and palpable carotid and radial pulses.2,3

Until recently, it was noted that in Spain, medical students received training through clinical simulation in a testimonial manner.4 However, we should mention that, in certain medical schools and teaching hospitals, simulation was introduced many years ago, and currently, we are experiencing a time when a portion of the investment in many educational centers is precisely focused on it. At hospital level, one of the first groups of intensivists interested in simulation as an educational tool was the group from Santander, with the so-called Center for Emergency Medicine Studies (CEMU), created in 1987. Quesada Suescun et al. created a school, and their magnificent center grew, which eventually led to the current Hospital Virtual Valdecilla (HvV).5 In medical schools, one of the first one to have a permanent Simulation structure was Valladolid, which created in 1995 four 40 m2 spaces dedicated to it. Currently, we have more than 200 m2 with 3 high-complexity simulation rooms, 1 low-complexity and early clinical immersion simulation room, 3 debriefing rooms, 2 offices, and 2 control centers. In them, cases of emergencies and urgencies are recreated, such as stroke intensive care, heart attack, intoxication, sepsis, polytrauma, hypoglycemia, seizures, dyspnea, heart failure, anaphylaxis, cranioencephalic trauma, digestive hemorrhage, smoke inhalation, or tachycardia, for 4th-, 5th-, and 6th-year medical students and, from the next academic year 2024–2025, for 3rd-year students.

In 2023, the Ministry of Health urged medical schools to increase the number of students by 706 per year. It is unquestionable that Simulation Centers in faculties and hospitals will play an essential role in complying with this mandate, as they allow reducing the number of students in hospitals and enable the analysis and training in decision-making in the face of a clinical problem.6 Additionally, simulation will be a tool that will shape the next era of postgraduate medical education, patient safety, and recertification of medical professionals.1,2