IntroductionVolume depletion is a common problem in pediatrics. Interns need to be able to recognize critical illness such as hypovolemic shock, obtain access, and manage complications. This simulation case involves a child with hypovolemic shock who requires intraosseous (IO) needle placement. While designed for subinterns in pediatrics, it is relevant for clerkship students and interns in family medicine and emergency medicine.MethodsIn this case, a 3-year-old child presents with vomiting, diarrhea, and lethargy, and is in hypovolemic shock. As IV access cannot be obtained, he requires IO access. Laboratory results reveal hypoglycemia, hypernatremia, and acute kidney injury. Required equipment includes an IV arm task trainer and a child mannequin with IO capacity (or a child mannequin plus a separate IO task trainer). Learning objectives include recognizing and managing hypovolemic shock, hypoglycemia, and electrolyte disturbances; obtaining IO access; and communicating with a distraught parent. Critical actions include attempting IO access, requesting labs, and administering fluids. Students complete a selfassessment survey following the case.ResultsA pilot study was conducted in 2017 with all subinterns (N = 16) on the pediatric service. Students' perceived competence in assessment and management of volume depletion and procedural skills such as IO placement were high following the session, and students rated the case as a highly beneficial learning experience.DiscussionThis clinical simulation case allows students to demonstrate clinical reasoning skills, procedural skills, and management skills regarding hypovolemic shock. It may be used as part of a curriculum for fourth-year students entering pediatric residency.

Introduction: Fever in early infancy is a common problem for which management can be challenging. All residents need to be able to recognize critical illness such as meningitis in febrile infants and manage complications such as seizures. Many new residents are not competent performing bedside procedures as there is little opportunity to perform them while in medical school. This simulation case revolves around fever and subsequent seizures in an infant. Designed to last 2 hours, the case is specific for subinterns but is relevant for clerkship students and interns in pediatrics, family medicine, and emergency medicine. Methods: In this case, a 5-week-old infant presents with fever and lethargy. He develops seizures with respiratory depression requiring antiseizure medication and respiratory support. His final diagnosis is bacterial meningitis. Major equipment required includes an infant mannequin and an infant lumbar puncture task trainer. Results: A pilot study was conducted in 2015 with all subinterns on the pediatric service. Students' perceived competence in diagnosis/management, procedural skills, and managing complex pediatric cases rose sharply after completing the session. Critical actions include obtaining IV access, performing blood and urine cultures, considering lumbar puncture, recognizing respiratory depression, performing bag and mask ventilation, administering antiseizure medication, counseling parents, and starting appropriate anti-infective therapy. Discussion: This clinical simulation case allows students to demonstrate clinical reasoning skills, procedural skills such as performing a lumbar puncture and bag-mask ventilation, and management skills. Materials are provided for students to perform selfassessments of perceived competency in procedural, diagnosis, and management skills related to the case.

Introduction: Although many medical schools are adding residency preparatory courses or boot camps to their curricula, there is little published guidance for faculty tasked with designing them. We developed a workshop and accompanying boot camp course design tool kit to assist faculty in creating a pediatric boot camp course following the initial steps of Kern's framework for curriculum development. Methods: Learners participated in a 2-hour workshop incorporating short didactics, guided independent reflection, and group discussions. Workshop facilitators guided faculty through the tool kit materials including a literature overview, a needs assessment worksheet, session prioritization and schedule planning worksheets, a module design worksheet, and implementation strategies. Results: Twenty-seven attendees at a national meeting of undergraduate pediatric educators participated in the workshop. Feedback was solicited via an anonymous electronic survey (41% completion rate), which indicated that attendees' self-assessed confidence significantly increased for each component of the tool kit. For the five tool kit components surveyed, average confidence increased 26% (range: 17.5%-37.1%) after completing the workshop. All respondents also indicated that the tool kit would be moderately helpful to very helpful as a stand-alone resource for independent faculty use, corresponding to a 3.57 out of 5 weighted average for this Likert-scale question. Discussion: We developed a pediatric boot camp course design workshop and tool kit to assist faculty in developing pediatric boot camps. Initial implementation was through a workshop, but the resource could be used individually and also adapted for use by other specialties.

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