SANTANDER-02-04 During their fourth year medical students have a 2 week course in anaesthesiology. The students are introduced to general anaesthesia by an anaesthesiologist in the operating room on a patient during routine clinical work. Our hypothesis was that an introduction using a full-scale patient simulator should give the students better self-confidence and less anxiety the first time they participated in giving a patient general anaesthesia. Methods: Twenty-four students were randomized to be introduced the traditional way or by using a METI Human Patient Simulator (HPS). The 'simulator.students', in groups of 3 or 4, had a short lecture in the cognitive loop of observation, assessment, decision making, action, and re-evaluation as applied to the anaesthetic procedure. In a scenario each student acted as anaesthetist performing a highly realistic induction, endotracheal intubation and awakening of the patient. Each student also experienced the identical sequence in the roles of the anaesthetic nurse, operating nurse, surgeon or observer. The instructor gave the student close guidance resulting in error-free anaesthesia management. The cognitive loop, communication and resource management was discussed during a debriefing session. After this introduction the 'simulator group' had the same 2 week clinical training in anaesthesia as the 'traditional group'. At the end of the 2 weeks all students answered a questionnaire. Thirteen questions focused on the student's feelings the first time he/she participated in giving general anaesthesia to a patient. Answers were given on a scale from 1 to 10. Data are given as median; the Mann-Whitney rank sum test was used as a post hoc test and P < 0.05 was considered significant. Results: For 10 of the questions there was no significant difference between the two groups, including the question 'Were you calm when you entered the operating room?' (P = 0.86). The 'simulator group' had significantly higher scores than the control group for the questions 'Did you understand how and when the anaesthesia machine should be used?' (7.5 vs. 4.5, P = 0.04), 'Was the situation at the induction familiar to you?' (7.0 vs. 3.5, P = 0.006), and 'How much responsibility did you feel you had for the patient?' (6.5 vs. 3.0, P = 0.02). Discussion: The 'simulator group' recognised the anaesthesia procedure in the messy anaesthetic working environment better than the 'traditional group'. This also supports the assumption that the simulator scenario was realistic. In reality the anaesthesiologist in charge has the medical responsibility for the patient, not the student. However, the 'simulator group' was prepared to shoulder more responsibility for the patient. This is probably due to more knowledge and training. Thus, we conclude that 'simulator' training enhances the student's self-confidence. An increased awareness of inherent risks in the anaesthetic procedure may explain that there was no difference regarding anxiety between the two groups.