Traditional Poster Round

Poster

Simulation-based medical training in pediatric residents in Italy: a national survey

Tuesday, May 15
09:45 - 10:45
Location: The Gate, Atrium 3rd Level

Background: : A prompt beginning of an appropriate neonatal and pediatric resuscitation is critical to reduce mortality and morbidity. However, residents are rarely exposed to real emergency situations (1). Simulation-based medical training (SBMT) offers the opportunity to improve medical skills in a controlled setting (2,3).

Research Question: : This survey describes the current use of SBMT in pediatric residency in Italy with the purpose to understand the expectations of residents with regard to neonatal and pediatric emergency training and to identify gaps and potential areas for future implementation.

Methodology: : A 40-question survey was developed by simulation experts from two Italian simulation centres, SIMNOVA (Novara) and SimMeyer (Florence) and distributed to Italian residents. SBMT was defined as any kind of training with a mannequin in a contextualised clinically realistic scenario, excluding international standardized courses. According to guidelines of the British Educational Research Association, surveys do not require an approval by any ethical review board.

Results: : Two hundred seventy-four (14%) residents answered from 71% of residency programs in Italy (25/35). The 88% of them spent less then 5 hours in SBMT in the 2015-2016 academic year and 66% not participating in any kind of simulation training. Seventy-one percent of respondents reported that their residency program did not offer SBMT in the field of neonatal and pediatric emergency care and in the 62% of residencies there was not a simulation-training laboratory. Of programs with SBMT, it was most focus on resuscitation (15%), psychosocial aspects of care (8%), and procedural skills (7%). The 93% of residents were interested in SBMT to improve decision-making abilities in complex medical situations, technical/procedural skills, overall competency in neonatal and pediatric emergency medicine, and non-technical skills. The main barriers to the implementation of SBMT programs in Italian pediatric residencies were: the lack of experts (57%), the lack of support from the school director (56%), the lack of organization in planning simulation centre courses (42%), and the lack of teaching materials (42%).

Discussion/Conclusions: : This survey shows the scarce use of SBMT during pediatric training in Italy and points out the main limitations to its diffusion. This is a call to act to develop organized SBMT during pediatric residency programs, to train qualified personnel and to research in this field to improve the quality of instruction and care.





Marco Binotti

MD
Neonatal and Pediatric Intensive Care Unit, Maggiore della Carità Hospital, Novara, Italy

Marco Binotti, MD, PhD Candidate.
Affiliations:
- Neonatal and Pediatric Intensive Care Unit, Maggiore della Carità Hospital, Novara, Italy
- Centro Interdipartimentale di Didattica Innovativa e di Simulazione in Medicina e Professioni Sanitarie - SIMNOVA, Università del Piemonte Orientale, Novara, Italy
Specific fields of interest: neonatal resuscitation, high fidelity simulation, medical teaching, brain sonography, echocardiography (particularly f-ECHO) and epidemiological research applied to neonatology.
Since 2015 Head of theneonatal and pediatric simulation program of simulation Center SIMNOVA (Novara, Italy).

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Giulia Genoni

MD
Division of Pediatrics, Department of Health Sciences, University of Piemonte Orientale, Novara, Italy
Novara, Italy

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Alice Monzani

MD
Division of Pediatrics, Department of Health Sciences, University of Piemonte Orientale, Novara, Italy

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Marco de Luca

ED Consultant
Meyer Children Hospital, Florence Italy

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Stefano Rizzollo

MD
Division of Pediatrics, Department of Health Sciences, University of Piemonte Orientale, Novara, Italy

I wes born in June, 29th 1979 in Pinerolo (Turin), Italy. I grown up in Beinasco a village near Turin, (Italy). I studied in Turin and I graduated in 1997, then I attended the Faculty of Medicine and Surgery of the University of Turin where I graduated in Medicine and Surgery March 12, 2009 with a thesis titled:"Anemia e deficit idiopatico dell'ormone della crescita: effetti della terapia sostitutiva con ormone della crescita ricombinante sui livelli di emoglobina".
From 08.24.2010 to 08.30.2011: Grantholder Doctor (project: “Collaborative multicenter international prospective study: use of fluconazole in preterm infants (TINN Project)”), S.C.D.O. Neonatology and NICU (Dir. Dr. D. Farina) University Hospital “Città della Salute e della Scienza” di Torino, Turin, Italy.
From 09.05.2011 to 08.31.2012: Volunteer Physician in S.C. Neonatology and NICU (Dir. Dr F. Ferrero) - Department for Health of Women and Children, University Hospital "Maggiore della Carità", Novara, Italy.
From 09.01.2012 to 05.31.2013: Grantholder Doctor (project: “Studio clinico di valutazione della sindrome metabolica nel bambino obeso” – “Clinical trial for the evaluation of the metabolic syndrome in obese children”) in Pediatric Clinic - Department for Health of Women and Children. University Hospital "Maggiore della Carità", Novara, Italy.
From 08.08.2013, I'm Resident Physician in Pediatric Clinic - Department for Health of Women and Children. University Hospital "Maggiore della Carità", Novara, Italy.

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Luca Carenzo

MD
SIMNOVA Simulation Center, University of Piemonte Orientale, Novara, Italy; Research Center in Emergency and Disaster Medicine (CRIMEDIM), University of Piemonte Orientale, Novara, Italy

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Martina Maddaluno

MD
Division of Pediatrics, Department of Health Sciences, University of Piemonte Orientale, Novara, Italy

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Ilaria Stasi

MD
Neonatal and Pediatric Intensive Care Unit, Maggiore della Carità Hospital, Novara, Italy

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Maria Rita Gallina

MD
Neonatal and Pediatric Intensive Care Unit, Maggiore della Carità Hospital, Novara, Italy

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Federica Ferrero

MD
Neonatal and Pediatric Intensive Care Unit, Maggiore della Carità Hospital, Novara, Italy

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Pier Luigi Ingrassia

MD, PhD
SIMNOVA Simulation Center, University of Piemonte Orientale, Novara, Italy; Research Center in Emergency and Disaster Medicine (CRIMEDIM), University of Piemonte Orientale, Novara, Italy

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David Kessler, MD, MSc

Assistant Professor of Pediatrics
Columbia University College of Physicians and Surgeons
Leonia, NJ

David Kessler, MD, MSc, is a longtime student of the growing art & science of simulation. David’s experience with simulation-based medical education, standardized patients, patient outcome oriented research, quality improvement, and change management has resulted to numerous grant-funded studies and peer-reviewed publications. As the director of clinical simulation for the Pediatric Emergency Medicine Division at Columbia University Medical Center David has focused on leveraging inter-professional simulation (in situ) to grow the culture of safety, strengthen teamwork/communication, and improve patient care. As co-director and one of the co-founders for INSPIRE, (International Network for Simulation-based Pediatric Innovation, Research and Education) an international pediatric research network focused on outcome oriented simulation research in acute care, resuscitation and skills—David has helped to grow a community of practice dedicated to collaboration and mentorship among investigators committed to scholarship in simulation. Personal interests include using simulation to plan and assess new clinical spaces, and integrating innovative technology into healthcare.

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