Traditional Poster Round
Context: : Within the Pediatric Emergency Medicine (PEM) fellowship, an initial program in simulation was developed in conjunction with the Patient Safety Institute (PSI), a simulation center for our health system (accredited by the Society for Simulation in Healthcare (SSH)). At that time, monthly mock-codes were preceded by didactic sessions; during simulation, fellows applied what had been taught during the associated didactic. The program was changed to unlink the mock-code from didactics, and to increase in-situ experiences. At this point, fellows wrote cases, but the quality of objectives was variable, and the case scenarios were not universally streamlined. Noticing this gap, we aimed to create a curriculum focusing on developing the fellows application of education theory. The two main goals of our intervention were to have fellows: (1) write evidence-based learning objectives using Bloom’s taxonomy and; (2) develop objective-driven case scenarios for simulation.
Description: : We developed an orientation day to familiarize the PEM fellows with high-fidelity simulation equipment, and the importance of writing clear learning objectives when developing scenarios. The day involved hands-on exposure to available equipment, followed by participation in a “mega code.” The case was then debriefed. After, participants were given the learning objectives; faculty demonstrated how the debrief addressed the planned objectives. The final portion of the session focused on the fellows as simulation instructors. Bloom’s taxonomy and the SSH guidelines for writing learning objectives were introduced.
For each upcoming month, PEM fellows rotate as the simulation instructor. The assigned fellow writes a case, which PEM faculty review. Feedback is given on both the objectives and the appropriateness of the case-progression. Once revised, cases are further reviewed by PSI faculty who provide additional feedback. Once finalized, the case is then implemented during fellow simulation sessions, and debriefed by faculty.
To enrich their experience as educators, fellows are encouraged to attend a systems-wide “simulation instructor course,” which focuses more specifically on structuring a debrief session and debrief techniques using advocacy-inquire. After, fellows are able to co-debrief with the faculty.
Observation/Evaluation: : All fellows participated in the initial orientation session. Since, 4 have taken on the role of simulation instructor for our monthly PEM by creating objective-driven cases. To date, 1 fellow has completed the entire curriculum to the point of co-debriefing their developed case. As the curriculum is currently being implemented, formal evaluation is in process.
Discussion: : Despite the initial orientation, fellows require significant mentorship and guidance in developing objectives and case scenario. Although not directly targeted by this intervention, fellows have expressed increased satisfaction as participants in simulation since the implementation of this curriculum.