Advances in simulation for pediatric critical care and emergency medicine.

PMID: 21494148

Curr Opin Pediatr. 2011 Apr 13. [Epub ahead of print]

Yager PH, Lok J, Klig JE.

aDivision of Pediatric Critical Care Medicine, Massachusetts General Hospital for Children, Massachusetts, USA bHarvard Medical School, Boston, Massachusetts, USA cDivision of Pediatric Emergency Medicine, Massachusetts General Hospital for Children, Massachusetts, USA.

Abstract

PURPOSE OF REVIEW: Routine integration of simulation into healthcare education and practice has gained momentum. Simulation is particularly important to acute and critical care pediatrics, as it offers alternative methods of training for high-risk and/or lower-frequency events in children. This review will discuss the recent advances in simulation education for pediatric critical care and emergency medicine and assess its potential for future growth through these subspecialties.

RECENT FINDINGS: Research indicates that simulation with a high-fidelity manikin is more realistic than with a simple manikin. Multievent simulation centers, on-site suites and mobile units for in-situ training offer a variety of venues for training. High-fidelity simulation is now used to identify performance gaps, enhance educational curricula and assess core competencies. A landmark study demonstrated improvement in outcomes from in-hospital pediatric cardiopulmonary arrest following the introduction of a pediatric simulation-based mock code program.

SUMMARY: High-fidelity simulation is emerging as a powerful tool for pediatric emergency medicine and critical care education through both individual and team-based training exercises. Programs can be tailored to meet specific institutional needs and budget limitations. As pediatric simulation-based programs evolve, further progress is anticipated in acute and critical care outcomes.

PMID: 21494148

Effect of a Simulation Educational Intervention on Knowledge, Attitude, and Patient Transfer Skills: From the Simulation Laboratory to the Clinical

Effect of a Simulation Educational Intervention on Knowledge, Attitude, and Patient Transfer Skills: From the Simulation Laboratory to the Clinical Setting

PubMed Id: 21487345

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Oʼdonnell JM, Goode JS Jr, Henker R, Kelsey S, Bircher NG, Peele P, Bradle J, Close J, Engberg R, Sutton-Tyrrell K.

From the Department of Acute/Tertiary Care, University of Pittsburgh School of Nursing (J.M.O., R.E., J.S.G., R.H.); Department of Epidemiology, University of Pittsburgh Graduate School of Public Health (S.K., K.S.-T., P.P., N.G.B.); University of Pittsburgh School of Medicine (N.G.B.); University of Pittsburgh School of Dental Medicine (J.C.); The Winter Institute for Simulation, Education and Research (WISER) (J.M.O.); Department of Anesthesiology, University of Pittsburgh Medical Center (N.G.B., J.S.G., J.B.); and

Abstract

INTRODUCTION: Musculoskeletal injury in the workplace is the primary work-related factor in loss of nursing personnel from the workforce. Moving or transferring patients is the dominant contributing event. A simulation educational approach has not been closely studied in this area but may have advantages over traditional approaches. Specific aims were to (1) evaluate the effect of a simulation intervention on success of patient transfers in a clinical setting and (2) measure change in participants' knowledge and attitude as a result of the intervention.

METHODS: A prospective, observational, longitudinal design was used. Baseline patient transfer observations were conducted on control and intervention units. An optimum task set was developed using hierarchical task analysis methods. Subjects (N = 71) completed pre- and postintervention knowledge and attitude assessments. The intervention consisted of simulated patient transfers using a mannequin, education, and training, followed by repeated simulated transfers using a mannequin with debriefing. Observations of patient transfers in patient care areas were repeated at 4 and 12 weeks.

RESULTS: Patient transfer success improved from 66% at baseline to 88% at the 4-week measurement point (t = 7.447, P ≤ 0.0004). At 12 weeks, transfer success had decreased to 71%, with addition of new employees between weeks 4 and 12 confounding the 12-week measurement. Knowledge improved from a baseline of 65% to 95% postsimulation intervention (z = -6.634, P ≤ 0.0004). Attitude change was also evaluated with significance seen with 12 of 15 items (P ≤ 0.05).

CONCLUSIONS: A simulation intervention was successful in significantly improving knowledge and changing subject perceptions with regard to this task. Skills acquired through simulation successfully transferred to the clinical setting. Improvement in success for patient moves not trained in the simulation laboratory suggests that acquired skills were generalizable and supports application to different settings.

PMID: 21487345 [PubMed - as supplied by publisher]