title: Impact of an embedded simulation team training programme in a paediatric intensive care unit: a prospective, single-centre, longitudinal study.
abstract: OBJECTIVE
  To evaluate the impact of an embedded simulation-based team training programme on perceived performance and to compare the effect over different phases of the programme.
  
  
  METHODS
  This was a prospective, single-centre, longitudinal study over the first 2 years of the programme. A total of 219 multidisciplinary health-care professionals participated in simulation sessions, followed by anonymous evaluation questionnaires. The programme was divided into three different phases: introductory (first 6 months), intermediate (second 6 months) and established phase (second year).
  
  
  RESULTS
  A total of 88.7% of participants evaluated the impact on overall practice as effective, 56.5% reported a highly effective impact. A total of 90.9% (391/430) of questions on non-technical skills (communication and teamwork) showed an effective impact, 55.6% a highly effective impact, whereas only 70.2% (262/373) of questions on technical skills showed an effective impact. There was a significant (p < 0.001) increased score for effective impact in all categories between the introductory and intermediate phase, which was maintained throughout the established phase. Overall, 72.7% of the participants felt more confident to attend a future critical event, 32.5% were highly confident. In the longitudinal analysis there was a stepwise significant (p < 0.05) increase of confidence of participants. In a subgroup analysis (n = 143) there was a significant (p < 0.001) higher confidence in participants who had attended at least 3 sessions (90.7 vs. 61%).
  
  
  CONCLUSIONS
  There is a 6- to 12-month learning curve in the implementation of an embedded multidisciplinary team training programme. Repeated exposure to simulation is most beneficial to crisis resource management training and single, isolated exposure may not be sufficient.
authors.affiliation: Paediatric Cardiorespiratory Intensive Care Unit, Royal Brompton and Harefield NHS Foundation Trust, Sydney Street, London SW3 6NP, UK. stockermartin@mail.com
authors.forename: Martin
authors.initials: M
authors.lastname: Stocker
authors.forename: Meredith
authors.initials: M
authors.lastname: Allen
authors.forename: Natasha
authors.initials: N
authors.lastname: Pool
authors.forename: Kumi
authors.initials: K
authors.lastname: De Costa
authors.forename: Julie
authors.initials: J
authors.lastname: Combes
authors.forename: Neil
authors.initials: N
authors.lastname: West
authors.forename: Margarita
authors.initials: M
authors.lastname: Burmester
mesh_terms: D000368:Aged; D005260:Female; D005602:France / Q000453:epidemiology; D017052:Hospital Mortality; D006801:Humans; D007318:Inservice Training / Q000379:methods*; D015278:Intensive Care Units, Pediatric; D033183:Interdisciplinary Communication; D008137:Longitudinal Studies; D008297:Male; D008485:Medical Audit; D008505:Medical Staff, Hospital / Q000193:education*; D008875:Middle Aged; D010348:Patient Care Team; D011446:Prospective Studies