Simulation-based training to enhance patient safety in pediatric cardiovascular care

Abstract

Pediatric cardiovascular care is delivered within clinical microsystems (operating room, catheterization laboratory, intensive care unit) characterized by complex teams and environments, high technical and cognitive demands, and need for frequent handovers. These features, also present in other high risk industries such as aviation and nuclear power, increase susceptibility to adverse events related to human error. In acute care areas of medicine broadly, and increasingly in pediatric cardiovascular care, simulation has emerged as an important tool to train individuals and teams in a structured environment far from patient harm to accelerate acquisition of technical skills, identify systems hazards, and reduce the risk of error due to human factors. Such simulation-based training programs are maximally effective when they are developed and delivered using rigorous, structured processes based on the principles of adult learning theory. Fundamental components of this process include formal needs assessment, development of scenarios that address specific learning objectives appropriately targeted to the level of the learner, and structured debriefing to aid learners in processing the simulation event. Recent innovations in simulation technology, such as development of high fidelity infant and pediatric-specific task trainers, are expanding the role of simulation in pediatric cardiovascular care.