[The simulated setting for testing competencies; task shifting in outpatient anaesthesia].

Pre-anaesthesia evaluation is a complex task requiring integration of information obtained from the patient's history, physical examination and the proposed surgery. This task, traditionally performed by physicians, is increasingly being executed by specialised nurses or physician assistants in daily practice. The conduction of pre-anaesthesia evaluation might be suitable for such a shift in tasks, but only if the quality of care is retained. A simulated setting could be used in which the competency of individual physician assistants executing pre-anaesthesia evaluation with sufficient quality is measured. Simulation to test competencies requires properly described competencies within an adequate and validated simulation model, a suitable and validated assessment system, and an understanding of the causes of errors in measurement. A simulation study with an adequate sample size to detect a given sensitivity of physician assistants of 80% to identify significant comorbidity during pre-anaesthesia evaluation would require simulation of 1,000 to 1,500 consults.