title: The role of high-fidelity simulation in training pediatric emergency medicine fellows in the United States and Canada.
abstract: OBJECTIVE
  The American Academy of Pediatrics Section on Emergency Medicine's Simulation Interest Group developed a survey targeting pediatric emergency medicine (PEM) fellowship program directors to assess the use of high-fidelity simulation (HFS) in PEM fellow training.
  
  
  METHODS
  Content experts in simulation and in PEM developed a 38-item Internet-based questionnaire that was distributed to PEM program directors via e-mail though www.surveymonkey.com.
  
  
  RESULTS
  Seventy-seven percent (51/66) of PEM program directors in the United States and Canada responded to the survey. Sixty-three percent of programs incorporate HFS in PEM fellowship training. For programs with HFS, the most frequent uses of HFS include (1) decision making for trauma resuscitations (97%, 31/32) and medical emergencies (91%, 29/32), and for the application of advanced life support (84%, 27/32); (2) technical skills: intubation (100%, 31/31), bag-mask ventilation (94%, 29/31), cardioversion/defibrillation (90%, 28/31), and difficult airway management (84%, 26/31). Of program directors without simulation, a majority valued simulation for PEM fellow training, and 59% (11/19) plan on expanding efforts. Perceived barriers to an active simulation program exist: lack of financial support (79%, 15/19), lack of simulator equipment (74%, 14/19), lack of a dedicated physical space (68%, 13/19), and insufficiently experienced simulation faculty (58% 11/19).
  
  
  CONCLUSIONS
  Sixty-three percent of PEM fellowship programs integrate HFS-based activities. The majority of PEM fellowship program directors value the role of HFS in augmenting clinical experience and documenting procedural skills. Regional simulation centers are one possible solution to offer HFS training to fellowships with limited financial support and/or lack of experienced simulation faculty.
authors.affiliation: Northwestern University Feinberg School of Medicine, Anne & Robert H. Lurie Children's Hospital of Chicago, IL, USA. w-eppich@northwestern.edu
authors.forename: Walter J
authors.initials: WJ
authors.lastname: Eppich
authors.forename: Michele M
authors.initials: MM
authors.lastname: Nypaver
authors.forename: Prashant
authors.initials: P
authors.lastname: Mahajan
authors.forename: Kent T
authors.initials: KT
authors.lastname: Denmark
authors.forename: Christopher
authors.initials: C
authors.lastname: Kennedy
authors.forename: Madeline Matar
authors.initials: MM
authors.lastname: Joseph
authors.forename: In
authors.initials: I
authors.lastname: Kim
mesh_terms: D002170:Canada; D003479:Curriculum; D004503:Education, Medical, Graduate / Q000458:organization & administration*; D004635:Emergency Medicine / Q000193:education*; D005257:Fellowships and Scholarships; D006801:Humans; D008348:Manikins; D010372:Pediatrics / Q000193:education*; D011795:Surveys and Questionnaires; D014481:United States