Impact of Simulation Training on Time to Initiation of Cardiopulmonary Resuscitation for First-Year Pediatrics Residents

Ross, Joshua; Trainor, Jennifer L.; Eppich, Walter; Adler, Mark

doi:10.4300/jgme-d-12-00343.1

Cited by 21 publications

(11 citation statements)

References 35 publications

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“… 8 , 10 Simulation-based education interventions reduce the time to call for help, initiate bag-mask ventilation (BVM), and start CPR for first-year pediatric residents. 11 Participants and observants in mock code programs have also reported increased self-confidence and comfort with knowledge during a code, as well as decreased anxiety. 12 , 13 Promisingly, an increased number of mock codes at one tertiary care academic medical center has been associated with improved survival rates from 33% to 50% in pediatric cardiopulmonary arrests.…”

Section: Introductionmentioning

confidence: 99%

Excellence in Communication and Emergency Leadership (ExCEL): Pediatric First 5 Minutes Workshop for Residents

et al. 2020

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Introduction: In-hospital pediatric cardiopulmonary arrest is associated with high morbidity and mortality, and appropriate initial management has been associated with improved clinical outcomes. Despite current training, pediatric residents often do not feel confident in their ability to deliver this initial management. This workshop focused on the initial management of critically ill pediatric patients and performance of high-quality CPR. Methods: This hands-on workshop utilized skill stations with low-and medium-fidelity simulators to instruct learners on initial management during the first 5 minutes of a code, including high-quality CPR. It was designed for residents across all levels of training who care for pediatric patients (including pediatrics, medicine-pediatrics, pediatrics, psychiatry, and child psychiatry, family medicine, and emergency medicine residents) and can be adapted for different session durations and group sizes. Results: This workshop was conducted at two separate institutions with a total of 18 resident participants. Participants strongly agreed that this workshop was relevant and effective in teaching the initial assessment and management of the critical pediatric patient, including how to best perform high-quality CPR. Residents further reported high levels of confidence in initially assessing and managing a critically ill patient, describing the markers of high-quality CPR, and performing high-quality CPR. Discussion: This workshop provided residents with additional instruction and practice in the initial management of critically ill pediatric patients in cardiopulmonary arrest. The structure and timeline of this curriculum can be adapted to the needs of the individual institution's program and the number of workshop participants.

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Section: Introductionmentioning

confidence: 99%

Excellence in Communication and Emergency Leadership (ExCEL): Pediatric First 5 Minutes Workshop for Residents

et al. 2020

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“…Simulation has been used in many settings to teach students and residents resuscitation skills. Simulation-based educational interventions have been shown to improve resident knowledge and performance in studies assessing simulation for neonatal and pediatric resuscitations [5–7], pediatric airway management [8], and time to initiation of CPR [9]. While these studies were conducted on high-fidelity simulators, there is also evidence that low-fidelity simulation can be effective, and that the transfer of learning is not dependent on the simulator fidelity [10].…”

Section: Introductionmentioning

confidence: 99%

Rapid cycle deliberate practice vs. traditional simulation in a resource-limited setting

et al. 2019

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Background We sought to develop a low-fidelity simulation-based curriculum for pediatric residents in Rwanda utilizing either rapid cycle deliberate practice (RCDP) or traditional debriefing, and to determine whether RCDP leads to greater improvement in simulation-based performance and in resident confidence compared with traditional debriefing. Methods Pediatric residents at the Centre Hospitalier Universitaire de Kigali (CHUK) were randomly assigned to RCDP or traditional simulation and completed a 6 month-long simulation-based curriculum designed to improve pediatric resuscitation skills. Pre- and post- performance was assessed using a modified version of the Simulation Team Assessment Tool (STAT). Each video-taped simulation was reviewed by two investigators and inter-rater reliability was assessed. Self-confidence in resuscitation, pre- and post-simulation, was assessed by Likert scale survey. Analyses were conducted using parametric and non-parametric testing, ANCOVA and intra-class correlation coefficients (ICC). Results There was a 21% increase in pre- to post-test performance in both groups ( p < 0.001), but no difference between groups (mean difference − 0.003%; p 0.94). Inter-rater reliability was exceptional with both pre and post ICCs ≥0.95 (p < 0.001). Overall, self-confidence scores improved from pre to post (24.0 vs. 30.0 respectively, p < 0.001), however, the there was no difference between the RCDP and traditional groups. Conclusions Completion of a six-month low-fidelity simulation-based curriculum for pediatric residents in Rwanda led to statistically significant improvement in performance on a simulated resuscitation. RCDP and traditional low-fidelity simulation-based instruction may both be valuable tools to improve resuscitation skills in pediatric residents in resource-limited settings. Electronic supplementary material The online version of this article (10.1186/s12909-019-1742-4) contains supplementary material, which is available to authorized users.

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“…Overall, the results in this study showed a significant improvement in team performance represented by a decrease in CPR initiation time after the mock code simulation program, in both the CRP initiation time analysis and the AHA adherence analysis, as both revealed faster CPR initiation, which may reflect that cardiac arrest recognition improved after the mock code simulation program, and the first responders initiated chest compression earlier. Other studies reported the same results related to the CPR initiation time, which was part of the team dynamics improvement in some of them [21,25,29]. In our study, we did not find significant changes in the survival rate after the mock code simulation program, but the small sample size, which is one of the major study limitations, may have affected the results and made these changes difficult to trace, while the results of other studies showed better outcomes after implementing mock code simulation programs [30].…”

Section: Discussionmentioning

confidence: 58%

“…Several studies support the use of resuscitation training programs that are multidisciplinary sessions based on the latest resuscitation guidelines. Furthermore, mock code training programs minimize performance differences and help to improve the response time from the onset of loss of pulse to the initiation of chest compressions, the time spent administering the first dose of epinephrine, and defibrillation time [13,[21][22][23][24][25].…”

Section: Introductionmentioning

confidence: 99%

The Impact of Mock Code Simulation on the Resuscitation Practice and Patient Outcome for Children With Cardiopulmonary Arrest

Hazwani¹,

Alosaimi²,

Almutairi³

et al. 2020

Cureus

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Background Cardiopulmonary arrest is an uncommon event in pediatric patients. Additionally, physicians-in-training see far fewer cardiopulmonary arrest events. Therefore, they have limited confidence in their resuscitation skills. Mock code training with active participation and debriefing may be an effective tool to fill this gap in experience. The aims of the study were to assess the impact of a mock code simulation program on patient outcome for children with cardiopulmonary arrest in a tertiary pediatric academic center and provide evidence that code simulations can improve the quality of cardiopulmonary resuscitation (CPR). Methods This was a retrospective cohort study conducted in a tertiary academic center. This study had two phases: Phase 1 before the mock code simulation program began (pre-intervention) and Phase 2 after the mock code program began (post-intervention). The data were collected from pediatric patients with cardiopulmonary arrest during the study period who met the inclusion criteria, and variables included the survival rate at hospital discharge, CPR initiation time, time to the first dose of epinephrine, and the adherence rate to American Heart Association (AHA) guidelines. Results A total of 13 patients in the pre-intervention period and 19 patients in the post-intervention period were included. The results showed a significant improvement in team performance represented by a decrease in CPR initiation time post-intervention and improvement in AHA adherence; however, the results did not show a significant difference in the survival rate or mortality within 28 days of the cardiopulmonary arrest event between the pre- and post-intervention groups. Conclusions Mock code simulation was a helpful tool to enhance team performance and improve the quality of cardiac resuscitation and cardiac arrest recognition, while its impact on the survival rate was not significant in our study.

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Impact of Simulation Training on Time to Initiation of Cardiopulmonary Resuscitation for First-Year Pediatrics Residents

Abstract: A simulation-based educational intervention significantly reduced time to initiation of CPR for first-year pediatrics residents. Simulation training facilitated acquisition of critical CPR skills that have the potential to impact patient outcome.

Cited by 21 publications

References 35 publications

Excellence in Communication and Emergency Leadership (ExCEL): Pediatric First 5 Minutes Workshop for Residents

Excellence in Communication and Emergency Leadership (ExCEL): Pediatric First 5 Minutes Workshop for Residents

Rapid cycle deliberate practice vs. traditional simulation in a resource-limited setting

The Impact of Mock Code Simulation on the Resuscitation Practice and Patient Outcome for Children With Cardiopulmonary Arrest

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