Traditional Poster Round
Context: : The goals of medical training and education in an academic pediatric intensive care unit (PICU) is to deliver timely, relevant, and high quality information to learners in an efficient and engaging manner that is not obstructive to workflow. While off-unit simulation training can provide high quality information and high-fidelity practical experience, this method can be time- and labor- intensive, obstructive to workflow, and often lack relevance to current PICU cases or the challenges of delivering high quality care in the actual unit environment. We implemented weekly in-situ simulation sessions in our PICU to enhance the medical training and education of pediatric critical care fellows, rotating residents, nursing, respiratory therapist, and other ancillary staff. While the benefit of in-situ simulations have been described in other care team environments, literature evaluating the feasibility and value of interdisciplinary in-situ simulation program in a large academic PICU has not been well described.
Description: : Interdisciplinary team-based in-situ simulation cases were designed based on real life cases of pediatric critical illness in our PICU. We utilized low fidelity sim mannequins and Laerdal® simulation monitor tablets obtained through REVIVE, a resuscitation simulation and patient safety organization at our children’s hospital. We collected unused but discarded medical equipment for use in the simulations to decrease the cost associated with medical equipment. Each simulation session was followed by a standardized debriefing session addressing pre-determined learning objectives. We would limit the simulation experience to a total of 20 minutes for the case and debrief to avoid major interruptions to workflow. A survey was administered after the experience to measure the value and satisfaction with the experience.
Observation/Evaluation: : The participants feedback was measured using a Likert scale. We have collected 10 unique survey responses since the initiation of in-situ simulation in October 2018. The roles of survey participants included pediatric residents, pediatric critical care fellows, pediatric critical care nurses, pharmacists, and respiratory therapists. The survey participants scored relevance to scope of practice 4.9/5, appropriate location for simulation as 4.9/5, debrief covering important teaching points as 4.8/5, and usefulness of the in-situ simulation scenarios as 4.9/5. We will continue to collect data as the program progresses. Write-in comments on the surveys suggest that they appreciate this intervention and would like more frequent in-situ simulation in the future.
Discussion: : The implementation of frequent in-situ simulations in a large academic PICU is feasible without interrupting the workflow of the unit and is valuable to the education of staff and trainees. An in-situ simulation curriculum allows for interdisciplinary training of rare and/or high acuity events in a real-life environment with the hope of increasing educational satisfaction of our staff and improving patient safety.