Learning to Beat the Shock Clock: A Low-Fidelity Simulation Board Game for Pediatric and Emergency Medicine Residents

Abstract

Introduction: Resident physicians may have difficulty with identifying and managing pediatric septic shock due to limited patient encounters. Simulation-based interventions can enhance competency. We developed a low-fidelity tabletop simulation game to teach pediatric septic shock and compared residents' knowledge of and comfort with recognition and management of septic shock. Methods: Pediatric and emergency medicine residents participated in an education session involving a low-fidelity, tabletop simulation in which they managed two simulated pediatric patients with septic shock. The two patients were a 12-year-old healthy male with cold shock due to a urinary tract infection and a 5-year-old female with a history of leukemia who developed warm shock due to pneumonia. Because this session was presented as a board game rather than high-fidelity simulation, learners focused on decision making rather than the mechanics of procedures. Residents completed a survey and a knowledge-based test before and after this session. Results: Twenty-three pediatric and nine emergency medicine residents participated. Correct responses for the preintervention test were 71%, compared with 83% postintervention. The difference in rates was 12% (95% confidence interval, -0.17 to -0.07; p < .0001). Residents rated this modality as being more useful than lectures or reading and as equivalent to bedside teaching and high-fidelity simulation. Discussion: Our pilot low-fidelity simulation improved resident knowledge and comfort with pediatric septic shock care. Further studies are needed to address the impact of low-fidelity simulations on patient outcomes.