Tehran University of Medical Sciences Frontiers in Emergency Medicine 2717-3593 8 3 2024 06 07 e26 e26 Maria Leis University of Toronto, Faculty of Medicine, 1 King’s College Cir, Toronto, Canada Brendan Kelly University of Toronto, Faculty of Medicine, 1 King’s College Cir, Toronto, Canada Rajani Vairavanathan University of Toronto, Faculty of Medicine, 1 King’s College Cir, Toronto, Canada 2024 03 17 2024 04 27 First trimester bleeding is commonly encountered in pregnancy and can be potentially life-threatening. Simulation training provides an ideal opportunity for resident medical learners to improve clinical knowledge and gain confidence in managing life-threatening causes of first trimester bleeding in a realistic but safe clinical environment. The objective of this study was to assess the effectiveness of simulation in improving family medicine residents’ confidence and knowledge in identifying and managing first trimester bleeding in the emergency department (ED). The intervention was a two-hour educational simulation focusing on management of unstable first trimester bleeding. Twenty-one family medicine residents (67% female) at the University of Toronto participated in the simulation and completed pre- and post-simulation questionnaires assessing their confidence and knowledge in management of first trimester bleeding. This study demonstrates that simulation training improves resident physicians’ confidence in managing first trimester bleeding in the ED. Additionally, it improves their objective history taking skills. Post-graduate medical programs should consider developing structured simulation, particularly for high-yield clinical cases residents may not otherwise have acute exposure to and are required to be competent in managing. https://fem.tums.ac.ir/index.php/fem/article/view/1371 https://fem.tums.ac.ir/index.php/fem/article/download/1371/486