Simulation of Pediatric Life-Threatening Emergency Scenarios (SimPLES): The Development, Implementation, and Evaluation of an Undergraduate Immersive Simulation-Based Educational Intervention

Abstract

Background: Clinical exposure to acutely unwell pediatric patients is often limited during undergraduate medical training. Although limited within undergraduate pediatric curricula, simulation-based education (SBE) offers a tool with which such exposure can be achieved in a safe and effective learning environment. This study describes the development, implementation, and evaluation of an undergraduate multi-center immersive pediatric SBE course. Objectives: We sought to increase medical students’ exposure to acutely unwell pediatric patients and provide practical experience to improve their understanding of the importance of non-technical skills within the clinical workplace, such as teamwork communication skills, leadership, and situational awareness. Furthermore, we sought to evaluate the impact on students’ confidence in assessing and managing acutely unwell pediatric patients while exploring their perceptions and opinions of the course. Methods: The present study included all final-year students who were on a pediatric clinical placement during the study period. Tutorials on pediatric A-E assessment and fluid management were followed by a series of immersive simulation scenarios and structured debriefs, concentrating on the importance of non-technical skills in the clinical workplace. Also, some mini-tutorials were incorporated into the course design, focussing on the technical and pathophysiological aspects of each presentation. We employed a mixed-method research methodology to evaluate the impact of the course. Also, the anonymized post-course and free-text feedback were sought to explore students’ experiences and perceptions of the course. Results: All 80 students completed the pre and post-course confidence questionnaires, reporting statistically significant improvements in confidence across all 11 domains tested. Thematic analysis of the qualitative data identified six core themes: knowledge acquisition, the value of debriefing, the importance of non-technical skills, the value of faculty expertise, the value of repeated practice, and opportunities for exposure to pediatrics. The innovative post-scenario mini-tutorials were favorably received received. Conclusions: Our study shows that immersive SBE can improve medical students’ confidence in managing pediatric emergency scenarios. Also, incorporating mini-tutorials within an immersive simulation course design in an undergraduate setting can be helpful and well received by students.

Child Health Essential Skills Stations (CHESS): Development, Implementation, and Evaluation of an Undergraduate Child Health Clinical Skills Course

“…Procedural skill competency has been identified multiple times as a weakness in curricula for training doctors (2,7,11). Inconsistent opportunities to observe or attempt procedures (2,11), minimal clinical exposure in child health settings (10,13), and a dearth of evidence on how to transfer skills training into the clinical environment (3,14) all act as barriers to students obtaining procedural competencies relating to child health. Disruption to attachments during the COVID-19 pandemic has exacerbated these existing deficiencies and created new challenges for educators training medical students in procedural skills (6).…”

“…However, final-year placements in child health might be the only clinical exposure students have in this specialty before graduation (10). This puts an onus on the child health placement to provide students with the necessary opportunities to learn and practice core skills before graduating as new doctors.…”