Introduction Simulation-based medical education (SBME) improves medical knowledge compared with no intervention. In traditional SBME, more time is spent debriefing than practicing skills. Rapid cycle deliberate practice (RCDP) simulation allows learners to practice skills repetitively, receive brief interspersed feedback, and has been shown to improve individual performance of resuscitation skills in simulation; it has not been compared with traditional simulation methods. Objective The aim of the study was to compare traditional and RCDP SBME. Methods Four pediatric resuscitation cases (3 for teaching and 1 for testing) were developed. For the RCDP arm, traditional cases were deconstructed into sequences of progressively difficult rounds. The last RCDP round served as the traditional arm scenario. Learners received 1 type of instruction on 2 separate days. Pretest and posttest performance during simulation were video recorded and scored using the Simulation Team Assessment Tool; satisfaction surveys were collected. Results Pretest team performance was similar in both groups. Simulation Team Assessment Tool score improvement for RCDP was 7.2% (95% confidence interval, 3.4% to 11%) and traditional was 0.8% (95% confidence interval, −11% to 13%). The difference in improvement of the human factors subscore was statistically significant; RCDP improved 10.2% and traditional improved 1.7% (P = 0.013). The RCDP technique was well received by learners but caused fatigue. Conclusions This pilot study showed a trend toward greater improvement in team performance and significantly greater improvement for human factors with RCDP compared with traditional simulation. Future studies comparing RCDP with other methods are needed to identify best practices and applications of RCDP, including which learners and learning objectives are best suited to RCDP.

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ObjectiveTo implement a curriculum using simulation and skills training to augment a Pediatric Emergency Medicine (PEM) rotation within a pediatric clerkship.BackgroundPEM faculty are often challenged with a high learner to teacher ratio in a chaotic clinical setting. This challenge was heightened when our pediatric clerkship's traditional 1-week PEM rotation (consisting of 4 students completing four 8-hour ED shifts/week) expanded to 8 students every 2 weeks. We sought to meet this challenge by integrating simulation-based education into the rotation.MethodsClerkship students from March to June 2012 completed our traditional rotation. Students between July and October 2012 completed the new PEM-SIM curriculum with 19 hours ED shifts/week and 16 hours/week of simulation/skills training. Pre/post-tests evaluated 1) medical management/procedural comfort (five-point Likert scale); and 2) PEM knowledge (15 multiple-choice questions).ResultsOne hundred and nine students completed the study (48 traditional, 61 PEM-SIM). Improvement in comfort was significantly higher for the PEM-SIM group than the traditional group for 6 of 8 (75%) medical management items (p<0.05) and 3 of 7 (43%) procedures, including fracture splinting, lumbar puncture, and abscess incision/drainage (p<0.05). PEM-SIM students had significantly more improvement in mean knowledge compared to the traditional group (p<0.001).ConclusionsWe have successfully integrated 16 hours/week of faculty-facilitated simulation-based education into a PEM rotation within our clerkship. This curriculum is beneficial in clinical settings with high learner to teacher ratios and when patient care experiences alone are insufficient for all students to meet rotation objectives.

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