title: Advances in simulation for pediatric critical care and emergency medicine.
abstract: OBJECTIVE
  Routine integration of simulation into healthcare education and practice has gained momentum. Simulation is particularly important to acute and critical care pediatrics, as it offers alternative methods of training for high-risk and/or lower-frequency events in children. This review will discuss the recent advances in simulation education for pediatric critical care and emergency medicine and assess its potential for future growth through these subspecialties.
  
  
  RESULTS
  Research indicates that simulation with a high-fidelity manikin is more realistic than with a simple manikin. Multievent simulation centers, on-site suites and mobile units for in-situ training offer a variety of venues for training. High-fidelity simulation is now used to identify performance gaps, enhance educational curricula and assess core competencies. A landmark study demonstrated improvement in outcomes from in-hospital pediatric cardiopulmonary arrest following the introduction of a pediatric simulation-based mock code program.
  
  
  CONCLUSIONS
  High-fidelity simulation is emerging as a powerful tool for pediatric emergency medicine and critical care education through both individual and team-based training exercises. Programs can be tailored to meet specific institutional needs and budget limitations. As pediatric simulation-based programs evolve, further progress is anticipated in acute and critical care outcomes.
authors.affiliation: Division of Pediatric Critical Care Medicine, Massachusetts General Hospital for Children, USA. pyager@partners.org
authors.forename: Phoebe H
authors.initials: PH
authors.lastname: Yager
authors.forename: Josephine
authors.initials: J
authors.lastname: Lok
authors.forename: Jean E
authors.initials: JE
authors.lastname: Klig
mesh_terms: D002648:Child; D003198:Computer Simulation; D003422:Critical Care; D003479:Curriculum; D004635:Emergency Medicine / Q000193:education*; D006801:Humans; D008348:Manikins; D016544:Patient Simulation; D018794:Problem-Based Learning / Q000379:methods