Traditional Poster Round
Context: : Large urban emergency departments (EDs) have low volume of high acuity pediatric presentations due to proximity to dedicated children’s hospitals. This leads to a waning of knowledge and skills for this unique population, and discomfort among ED staff in managing these patients. At our institution, 68% of ED staff indicated they managed paediatric patients in less than a quarter of shifts, were uncomfortable managing an unwell neonate, or were uncomfortable teaching a paediatric topic to trainees. To address this, a modular, inter-professional curriculum on paediatric emergencies was developed.
We hypothesize that formal in-situ simulation-based paediatric curriculum utilizing a progressive segmental strategy is feasible and useful in maintaining competence as well as addressing and uncovering important system gaps.
Description: : A needs assessment was conducted to inform curriculum objectives. Experts in simulation, nursing education, and pediatric emergencies designed a full-day, RCPSC accredited, interprofessional simulation program. Each module consisted of a didactic pre-reading paired with a corresponding simulation day. Each simulation day comprised of 4 rotating skills stations using a deliberate practice approach, followed by a high fidelity simulation. Two paediatric scenarios ran in parallel for 20 minutes, with 40 minutes of debriefing led by a content expert using formalized checklists.
Observation/Evaluation: : Post-training anonymous evaluation forms were distributed to participants to quantify knowledge translation and identify system gaps. Debriefing sessions were transcribed and disseminated to key stakeholders.
All participants reported the experience to be relevant and helpful in increasing knowledge base. All participants requested more frequent simulation days. 95% of participants stated that there was sufficient time during skills session to practice the skills. Identified system gaps were in the areas of communication, equipment, and patient safety.
Discussion: : Maintaining skills for paediatric patients is an important component of continuing professional development for EDs with low volume of high acuity paediatrics. This novel curriculum addressed this need and led to the formation of an accountability committee to ensure action on key issues. Future simulations will not only continue to deliver accredited continuing medical education and identify system gaps, but also serve as a tool to evaluate response to identified gaps.