title: Simulation-based mock codes significantly correlate with improved pediatric patient cardiopulmonary arrest survival rates.
abstract: OBJECTIVE
  To evaluate the viability and effectiveness of a simulation-based pediatric mock code program on patient outcomes, as well as residents' confidence in performing resuscitations. A resident's leadership ability is integral to accurate and efficient clinical response in the successful management of cardiopulmonary arrest (CPA). Direct experience is a contributing factor to a resident's code team leadership ability; however, opportunities to gain experience are limited by relative infrequency of pediatric arrests and code occurrences when residents are on service.
  
  
  METHODS
  Longitudinal, mixed-methods research design.
  
  
  METHODS
  Children's hospital at an tertiary care academic medical center.
  
  
  METHODS
  Pediatric.
  
  
  METHODS
  Clinicians responsible for pediatric resuscitations responded to mock codes randomly called at increasing rates over a 48-month period, just as they would an actual CPA event. Events were recorded and used for immediate debriefing facilitated by clinical faculty to provide residents feedback about their performance.
  
  
  METHODS
  Self-assessment data were collected from all team members. Hospital records for pediatric CPA survival rates were examined for the study duration.
  
  
  RESULTS
  Survival rates increased to approximately 50% (p = .000), correlating with the increased number of mock codes (r = .87). These results are significantly above the average national pediatric CPA survival rates and held steady for 3 consecutive years, demonstrating the stability of the program's outcomes.
  
  
  CONCLUSIONS
  This study suggests that a simulation-based mock code program may significantly benefit pediatric patient CPA outcomes-applied clinical outcomes-not simply learner perceived value, increased confidence, or simulation-based outcomes. The use of mock codes as an integral part of residency programs could provide residents with the resuscitation training they require to become proficient in their practice. Future programs that incorporate transport scenarios, ambulatory care, and other outpatient settings could further benefit pediatric patients in prehospital contexts.
authors.affiliation: Department of Medical Education, University of Michigan, Ann Arbor, MI, USA. pandreat@umich.edu
authors.forename: Pamela
authors.initials: P
authors.lastname: Andreatta
authors.forename: Ernest
authors.initials: E
authors.lastname: Saxton
authors.forename: Maureen
authors.initials: M
authors.lastname: Thompson
authors.forename: Gail
authors.initials: G
authors.lastname: Annich
mesh_terms: D016887:Cardiopulmonary Resuscitation / Q000193:education*; D002983:Clinical Competence; D004503:Education, Medical, Graduate / Q000379:methods*; D004521:Educational Measurement; D006323:Heart Arrest / Q000628:therapy*; D006776:Hospitals, Pediatric; D006801:Humans; D007396:Internship and Residency; D008137:Longitudinal Studies; D008348:Manikins; D008824:Michigan; D010372:Pediatrics / Q000193:education*; D011446:Prospective Studies; D015996:Survival Rate