T Ahluwalia1,2, S Toy3, C Gutierrez4,5, K Boggs5, K Douglass6. 1. Division of Emergency Medicine, Children's National Medical Center, 111 Michigan Ave NW, Washington DC, 20010, USA. tahluwalia@childrensnational.org. 2. Department of Pediatrics, Children's National Medical Center, 111 Michigan Ave NW, Washington, DC, 20010, USA. tahluwalia@childrensnational.org. 3. Department of Anesthesiology and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, USA. 4. Division of Emergency Medicine, Children's National Medical Center, 111 Michigan Ave NW, Washington DC, 20010, USA. 5. Department of Pediatrics, Children's National Medical Center, 111 Michigan Ave NW, Washington, DC, 20010, USA. 6. George Washington University School of Medicine and Public Health, Washington DC, USA.
Abstract
BACKGROUND: Pediatric emergency medicine training is in its infancy in India. Simulation provides an educational avenue to equip trainees with the skills to improve pediatric care. We hypothesized that a simulation-based curriculum can improve Indian post-graduate emergency medicine (EM) trainees' self-efficacy, knowledge, and skills in pediatric care. METHODS: We designed a simulation-based curriculum for management of common pediatric emergencies including sepsis, trauma, and respiratory illness and pediatric-specific procedures including vascular access and airway skills. Training included didactics, procedural skill stations, and simulation. Measures included a self-efficacy survey, knowledge test, skills checklist, and follow-up survey. Results were analyzed using the Wilcoxon signed-rank test and paired-samples t test. A 6-month follow-up survey was done to evaluate lasting effects of the intervention. RESULTS: Seventy residents from four academic hospitals in India participated. Trainees reported feeling significantly more confident, after training, in performing procedures, and managing pediatric emergencies (p < 0.001). After the simulation-based curriculum, trainees demonstrated an increase in medical knowledge of 19% (p < 0.01) and improvement in procedural skills from baseline to mastery of 18%, 20%, 16%, and 19% for intubation, bag-valve mask ventilation, intravenous access, and intraosseous access respectively (p < 0.01). At 6-month follow-up, self-efficacy in procedural skills and management of pediatric emergencies improved from baseline. CONCLUSIONS: A simulation-based curriculum is an effective and sustainable way to improve Indian post-graduate EM trainees' self-efficacy, knowledge, and skills in pediatric emergency care.
BACKGROUND: Pediatric emergency medicine training is in its infancy in India. Simulation provides an educational avenue to equip trainees with the skills to improve pediatric care. We hypothesized that a simulation-based curriculum can improve Indian post-graduate emergency medicine (EM) trainees' self-efficacy, knowledge, and skills in pediatric care. METHODS: We designed a simulation-based curriculum for management of common pediatric emergencies including sepsis, trauma, and respiratory illness and pediatric-specific procedures including vascular access and airway skills. Training included didactics, procedural skill stations, and simulation. Measures included a self-efficacy survey, knowledge test, skills checklist, and follow-up survey. Results were analyzed using the Wilcoxon signed-rank test and paired-samples t test. A 6-month follow-up survey was done to evaluate lasting effects of the intervention. RESULTS: Seventy residents from four academic hospitals in India participated. Trainees reported feeling significantly more confident, after training, in performing procedures, and managing pediatric emergencies (p < 0.001). After the simulation-based curriculum, trainees demonstrated an increase in medical knowledge of 19% (p < 0.01) and improvement in procedural skills from baseline to mastery of 18%, 20%, 16%, and 19% for intubation, bag-valve mask ventilation, intravenous access, and intraosseous access respectively (p < 0.01). At 6-month follow-up, self-efficacy in procedural skills and management of pediatric emergencies improved from baseline. CONCLUSIONS: A simulation-based curriculum is an effective and sustainable way to improve Indian post-graduate EM trainees' self-efficacy, knowledge, and skills in pediatric emergency care.
Authors: David A Cook; Ryan Brydges; Stanley J Hamstra; Benjamin Zendejas; Jason H Szostek; Amy T Wang; Patricia J Erwin; Rose Hatala Journal: Simul Healthc Date: 2012-10 Impact factor: 1.929