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Multiple factors influence the dependability of intensive care provision. The management of a group of unstable, critically ill patients requires focused attention from the clinical team. Medical simulation is an important tool to improve safety and team work within the ICU.The critical care healthcare team needs to work both individually and together in such a way as to optimise patient care and prevent error. This involves nontechnical skills including decision making, task allocation, team working and situation awareness, all of which are underpinned by communication, cooperation and coordination. The use of integrated simulators to create realistic patient scenarios with structured debriefing is an excellent method for teaching in these domains. There has been a huge increase in the delivery of training and education using an expanding variety of clinical simulators.This review summarises the evidence and opinion about how simulation tools can be optimally used. In addition, we propose an educational strategy to optimise the impact on clinical practice by embedding simulation training in a multidisciplinary teaching programme based upon a specifically developed curriculum focusing on the teaching of crisis resource management and patient safety.