Blueprint for community emergency department pediatric simulation

Abstract

BackgroundGaps in quality of pediatric emergency care have been noted in community emergency departments (CEDs), where >85% of children receive care. In situ simulation provides opportunities for hands‐on experiences and can help close these gaps. We aimed to develop, implement, and evaluate an innovative, replicable, and scalable pediatric in situ simulation‐based CED curriculum, under the leadership of a local colleague, through collaborative approach with a regional academic medical center (AMC).MethodsKern's model was used as follows: problem identification and general needs assessment—pediatric readiness assessment and discussions with CED physician and nursing leadership; targeted needs assessment—review of recent pediatric transfer cases; goals and objectives—enhance pediatric knowledge and skills of interprofessional teams and detect latent safety threats; educational strategies—codeveloped by CED and AMC, included prelearning using podcasts and videos, simulation and facilitated debriefing, resource sharing after simulations; implementation—3‐h simulation sessions facilitated in person by the CED team and remotely by AMC (leadership required participation and paid staff); and evaluation and feedback—retrospective pre–post survey, Simulation Effectiveness Tool–Modified (SET‐M), Net Promoter Score (NPS), and review/feedback meetings.ResultsBased on needs assessment, the selected cases included newborn resuscitation, seizure, asthma, and tetrahydrocannabinol ingestion causing altered mental sensorium in a child. Twenty‐four 3‐h simulation sessions were conducted over 1 year. A total of 168 participants completed the sessions, while 75 participants (54.7% nurses, 22.7% physicians, and others) completed feedback surveys. Seventy‐six percent of participants reported completing presimulation education material. Participants reported improved skills at appropriately evaluating a critically ill newborn and critically ill infant/toddler and improved teamwork during the care of a pediatric patient. The majority agreed that simulation was effective in teaching pediatric resuscitation. The NPS was 84% (excellent).ConclusionsA locally facilitated CED in situ simulation curriculum was successfully developed and implemented under local leadership, with remote collaboration by AMC. The curriculum was well received and effective.