PEDIATRIC SIMULATION IN EMERGENCY MEDICINE RESIDENCY TRAINING

Abstract

BACKGROUND: Simulation based training is correlated with improved outcomes in pediatrics and as an educational modality, has been widely adopted in pediatric emergency medicine. This is especially important given the infrequent nature of high acuity events in pediatrics, even amongst high volume centers. However, the majority of children are still cared for outside of pediatric centers. Because general emergency departments see large numbers of children, it is important that pediatric training be robust in emergency medicine training. Prior research has shown that there is a positive correlation between simulation based learning programs with improved pediatric outcomes. While most emergency medicine programs in Canada have integrated simulation into their programs, it remains unclear how pediatric specific simulation has been incorporated. OBJECTIVES Determine if and how pediatric simulation is formally integrated into existing simulation curricula in Emergency Medicine training programs. Determine barriers of implementation of pediatric simulation. DESIGN/METHODS: An anonymous cross-sectional survey was sent to program directors of Royal College accredited emergency medicine programs across Canada. RESULTS Number of Programs Responding 8 Pediatric resuscitation is part of the Yes 100% No 0% formal curriculum? How is pediatric simulation used? Resuscitation with high fdelity 100% Resuscitation with low fdelity 37.5% Procedural training 50% Team training 37.5% Evaluation 12.5% Where are pediatric simulations Stand alone simulation center 100% run? In situ 50% Where do your simulation Online simulation bank 25% scenarios come from? Institutional simulation Bank 75% Other 12.5% What are the barriers to Lack of faculty time 75% Lack of implementation of pediatric faculty with simulation training simulation in your institution? 62.5% Lack of physical space 50% Lack of protected learner time 37.5% Lack of resources (physical/fnancial) 50% Lack of curriculum resources 25% Pediatric simulation is most Procedural competency 50% important for: Resuscitation training 100% Team training 75% What areas of pediatric simulation Neonatal resuscitation 75% Pediatric require most attention? resuscitation 75% Procedural com-petency 37.5% Diffcult conversa tions 25% Would you use a pediatric Yes 37.5% No 12.5% Maybe 50% simulation curriculum developed by a national committee? CONCLUSION: The survey shows that all programs report formal integration of pediatric simulation into their residency curricula. Most programs use pediatric simulation to practice high stakes/rare events and report needs in neonatal and pediatric resuscitation in particular. Use of simulation as an evaluative tool remains uncommon. The most significant barriers in implementing simulation relate to human resources. Programs appear reluctant to use nationally developed curricula.