Marie-Hélène Lizotte1, Véronique Latraverse2, Ahmed Moussa3, Christian Lachance1, Keith Barrington1, Annie Janvier4. 1. Departments of Pediatrics, and. 2. Hôpital Pierre-Boucher, Montréal, Canada. 3. Departments of Pediatrics, and Mother-Child Simulation Center, Hôpital Sainte-Justine, University of Montreal, Montreal, Canada; and. 4. Departments of Pediatrics, and Clinical Ethics, and anniejanvier@hotmail.com annie.janvier.hsj@ssss.gouv.qc.ca.
Abstract
BACKGROUND: The acceptability of simulated death has been debated by experts, but there is scarce information regarding trainees' perspective. METHODS: Trainees in a large pediatric program were invited to perform mock codes, including pre and post questionnaires. Participants were exposed to 2 mock codes of neonates born pulseless. In the RESUSC scenario, the manikin responded to adequate resuscitation; in the DEATH scenario, the manikin remained pulseless. Mock codes were videotaped and evaluated by using the Neonatal Resuscitation Program score sheet. Debriefing was analyzed by using qualitative methodology. RESULTS: Fifty-nine of 62 trainees answered the questionnaire, and 42 performed a total of 84 mock codes. All trainees found mock codes beneficial and would appreciate being exposed to more. Most found them realistic and 78% agreed with the following statement: "During mock codes the manikin improves when adequate resuscitation steps are provided." The scenario or order of scenario did not affect performance (RESUSC versus DEATH). Only 1 trainee stopped resuscitation after 10 minutes of asystole; 31% had not ceased resuscitation efforts by 20 minutes. During debriefing and post questionnaire, trainees found the DEATH scenario more stressful than RESUSC. Trainees all answered the following question during debriefing: "How did this go for you?" Two themes were identified in their answers: (1) the manikin does not die; and (2) death equals inadequate resuscitation. CONCLUSIONS: The death of the manikin was stressful, but trainees thought this was acceptable and prepared them for their future. Trainees did not state that "death disclosures" were necessary before a simulated death.
BACKGROUND: The acceptability of simulated death has been debated by experts, but there is scarce information regarding trainees' perspective. METHODS: Trainees in a large pediatric program were invited to perform mock codes, including pre and post questionnaires. Participants were exposed to 2 mock codes of neonates born pulseless. In the RESUSC scenario, the manikin responded to adequate resuscitation; in the DEATH scenario, the manikin remained pulseless. Mock codes were videotaped and evaluated by using the Neonatal Resuscitation Program score sheet. Debriefing was analyzed by using qualitative methodology. RESULTS: Fifty-nine of 62 trainees answered the questionnaire, and 42 performed a total of 84 mock codes. All trainees found mock codes beneficial and would appreciate being exposed to more. Most found them realistic and 78% agreed with the following statement: "During mock codes the manikin improves when adequate resuscitation steps are provided." The scenario or order of scenario did not affect performance (RESUSC versus DEATH). Only 1 trainee stopped resuscitation after 10 minutes of asystole; 31% had not ceased resuscitation efforts by 20 minutes. During debriefing and post questionnaire, trainees found the DEATH scenario more stressful than RESUSC. Trainees all answered the following question during debriefing: "How did this go for you?" Two themes were identified in their answers: (1) the manikin does not die; and (2) death equals inadequate resuscitation. CONCLUSIONS: The death of the manikin was stressful, but trainees thought this was acceptable and prepared them for their future. Trainees did not state that "death disclosures" were necessary before a simulated death.
Authors: Chang H Park; Douglas Wetmore; Daniel Katz; Samuel DeMaria; Adam I Levine; Andrew T Goldberg Journal: BMJ Simul Technol Enhanc Learn Date: 2017-12-09