傳統的急診專科醫師訓練，多依賴從處理真實病志狀況，不斷學習成長。這樣的方式雖然可以藉 由實際的挑戰累積經驗，但對指導者來說，如何在病患安全及學習成效間取得平衡是一大難題。災難醫 學以及罕見案例的訓練，則是另一個焦點。這些事件極少發生，或許在訓練期間從未過過，但一旦面對， 卻又需要快速且正確的判斷處置。過去我們多使用經驗分享教學、桌上演練（tabletop exercise）、或演習的 方式進行訓練。然而，臨場鼠不足是學員常反映的問題。近年來，藉由高擬真假人情境演練，我們讓急 診醫護團隊，甚至料部之間，對許多重大傷病及特殊狀況的處置，提升效率。本文將分享模擬醫學訓練 在急重症方面的經驗，同時也探討在災難演練的應用。

Traditionally, the training of emergency physicians relies largely on dealing with real clinical problems and learning through experiences. Our residents accumulate a lot of experiences and knowledge; however, for the instructor, it might be difficult to find the balance between patient safety and adequate training. Disaster medicine and training for uncommon cases also gained attention. These events happen very rarely, might not even be encountered during training, but once it happens, rapid and correct management is critical. In the past, we used classroom sharing, tabletop exercise, and drills for training. Yet, trainees often complained that these programs lacked sense of reality. Recently, with the aid of high-fidelity medical simulator, we provided training programs to improve the ability of emergency department team to manage critical diseases and special conditions. We also held workshop to promote the efficiency of inter-department cooperation. This article describes our experience of medial simulation in emergency medicine and its applications in disaster medicine.