Using screen-based simulation to improve performance during pediatric resuscitation

Kevin J. Biese, Donna Moro-Sutherland, Robert D. Furberg, Brian Downing, Larry Glickman, Alison Murphy, Cheryl L. Jackson, Graham Snyder, Cherri Hobgood

Research output: Contribution to journalArticlepeer-review

16 Scopus citations

Abstract

Objectives: To assess the ability of a screen-based simulation-training program to improve emergency medicine and pediatric resident performance in critical pediatric resuscitation knowledge, confidence, and skills. Methods: A pre-post, interventional design was used. Three measures of performance were created and assessed before and after intervention: a written pre-course knowledge examination, a self-efficacy confidence score, and a skills-based high-fidelity simulation code scenario. For the high-fidelity skills assessment, independent physician raters recorded and reviewed subject performance. The intervention consisted of eight screen-based pediatric resuscitation scenarios that subjects had 4 weeks to complete. Upon completion of the scenarios, all three measures were repeated. For the confidence assessment, summary pre- and post-test summary confidence scores were compared using a t-test, and for the skills assessment, pre-scores were compared with post-test measures for each individual using McNemar's chi-square test for paired samples. Results: Twenty-six of 35 (71.3%) enrolled subjects completed the institutional review board-approved study. Increases were observed in written test scores, confidence, and some critical interventions in high-fidelity simulation. The mean improvement in cumulative confidence scores for all residents was 10.1 (SD ±4.9; range 0-19; p < 0.001), with no resident feeling less confident after the intervention. Although overall performance in simulated codes did not change significantly, with average scores of 6.65 (±1.76) to 7.04 (±1.37) out of 9 possible points (p = 0.58), improvement was seen in the administering of appropriate amounts of IV fluids (59-89%, p = 0.03). Conclusions: In this study, improvements in resident knowledge, confidence, and performance of certain skills in simulated pediatric cardiac arrest scenarios suggest that screen-based simulations may be an effective way to enhance resuscitation skills of pediatric providers. These results should be confirmed using a randomized design with an appropriate control group.

Original languageEnglish (US)
Pages (from-to)S71-S75
JournalAcademic Emergency Medicine
Volume16
Issue numberSUPPL. 2
DOIs
StatePublished - Dec 2009
Externally publishedYes

Keywords

  • Pediatric resuscitation
  • Screen based
  • Simulation

ASJC Scopus subject areas

  • Emergency Medicine

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