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Training Video Effects on Pediatric Resuscitation Team Performance Using a Modified Validated Assessment Tool

Tuesday, May 15
11:00 - 12:30
Location: Neptune 1&2

Background: : Simulation Based Medical Education (SBME) has been shown to improve technical and nontechnical skills and provide more frequent opportunities for pediatric providers to train for high-stakes, low-frequency events. To date, there are no studies evaluating the changes in team performance after observing an educational video intervention demonstrating optimal patient management as outlined by Pediatric Advanced Life Support guidelines from the American Heart Association.

Research Question: : We aimed to determine whether the implementation of a training video for simulated pediatric cardiac arrest would affect team performance as measured by a modified, validated Tool for Resuscitation Assessment Using Computerized Simulation (TRACS) scoring method.

Methodology: : Stony Brook University IRB waived the need for review of the study. Simulations conducted in a high-fidelity simulation suite in a university teaching hospital between July 2014 and June 2017 were scored with the modified TRACS. The intervention of the training video was released in October 2015 to all pediatric residents. Thirty sessions before and 21 sessions after the interventional video were tabulated. The credentials (resident or nurses) and number of participants were recorded for each session. The TRACS scores were sub-divided into four categories: Basics (B), Airway and Breathing (AB), Circulation and Rhythm (CR) and Competency and Behavior (CB). Each item in the sub-categories were scored by one trained technician.

Results: : Total TRACS scores (and domain sub-scores) pre-and post-viewing of the instructional video were compared using t-tests, repeated measures Analysis of Covariance, and Chi-Square tests. A p-value of <0.05 was considered statistically significant. From the 30 pre-intervention to the 21 post-intervention sessions, the mean scores increased in the AB, CR and CB categories, but none were statistically significant. Controlling for presence of residents and nursing, there was a significant improvement in the group score for the AB category (p = 0.019). Analysis of individual TRACS tool items showed a significant improvement in the CB item “feedback communication demonstrated” in the post-intervention (p = 0.011) group.

Discussion/Conclusions: : Although mean scores improved in three categories, there were no significant change in overall team performance after implementation of the training video. There was improvement in team airway and breathing performance measures when controlling for team characteristics. Feedback communication improved significantly after implementation of the video. Limitations of the study include sample size and unknown number of views by participants of the video. The study demonstrated areas of performance needing improvement. Using the modified TRACS scoring may be a feasible method to assess team performance for pediatric SBME and help identify areas for improvement.





Jennifer Lutz Cifuni, MD

Resident, Pediatrics
Stony Brook Children's Hospital
Stony Brook, New York

Dr. Cifuni, DO is a senior pediatric resident at Stony Brook Children’s Hospital in New York. She received her Bachelor of Science degree from Lafayette College in Pennsylvania. Dr. Cifuni worked at the Feinstein Institute for Medical Research in New York followed by her medical school training at the New York College of Osteopathic Medicine. During her medical training, Dr. Cifuni developed her interest in simulation-based education and will return to participate in the Simulation Olympics in New York City just before completing her residency this June. Dr. Cifuni will then start her position as Chief Pediatric Resident at Stony Brook Children’s Hospital in July 2018.

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Rahul S. Panesar, MD

Associate Professor, Pediatrics
Stony Brook Children's Hospital
Stony Brook, New York

Dr. Rahul Panesar is an Associate Professor at Stony Brook Children's Hospital in New York. He is a intensivist who practices Critical Care Medicine in the pediatric ICU. Dr. Panesar also is the director of the Pediatric Simulation Program, which offers a variety of high-fidelity and in-situ simulation sessions to residents, nurses, therapists and medical students.

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