Increasing pediatric resident simulated resuscitation performance: a standardized simulation-based curriculum.
OBJECTIVE
Studies demonstrating the impact of resuscitation simulation curricula on performance are limited. Our objective was to create and evaluate a simulation-based resuscitation curriculum's impact on pediatric residents' performance in a simulated resuscitation.


METHODS
We developed a standardized simulation-based pediatric resident resuscitation curriculum consisting of nine modules, incorporating four domains (basic skills, airway/breathing, circulation and team management) and specific topics (e.g., anaphylaxis). Each module was presented four times over the academic year. Evaluation of the curriculum consisted of pre- and post-intervention video-recorded performances of a simulated pediatric resuscitation by 10 resident resuscitation teams, scored using the Simulation Team Assessment Tool (STAT). The effectiveness of the standardized curriculum on medical (basics, airway/breathing, circulation) and team management, and on knowledge test scores was evaluated by comparing pre- and post-intervention STAT scores using unpaired two-sided T-test. The impact of group curriculum participation on team performance (STAT scores) was analyzed using linear regression.


RESULTS
Overall team performance STAT scores increased post-intervention (mean pre-test 0.61, post-test 0.74, p<0.001), as did management of the basics of resuscitation, airway/breathing and teamwork (mean basics: pre 0.46, post 0.62, p=0.001; mean airway/breathing: pre 0.63, post 0.76, p=0.01; mean teamwork: pre 0.61, post 0.79, p=0.003). Regression analysis provided evidence for a training "dose-response" among the post-intervention teams, with teams exposed to more training achieving higher performance scores (p=0.004).


CONCLUSIONS
We created a standardized simulation-based pediatric resuscitation curriculum that increased pediatric residents' scores on medical management and teamwork skills in a dose dependent relationship.
Department of Pediatrics, University of Washington School of Medicine and Division of Emergency Medicine, Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA 98105, United States. Electronic address: kimberly.stone@seattlechildrens.org.
Kimberly
K
Stone
Department of Pediatrics, University of Washington School of Medicine and Division of Emergency Medicine, Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA 98105, United States.
Jennifer
J
Reid
Department of Pediatrics, University of Washington School of Medicine and Division of Emergency Medicine, Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA 98105, United States.
Derya
D
Caglar
Center for Clinical and Translational Research, Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA 98105, United States.
Ana
A
Christensen
Center for Clinical and Translational Research, Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA 98105, United States.
Bonnie
B
Strelitz
Incyte Corporation, Experimental Stations E361/256A, Route 141 and Henry Clay Road, Wilmington, DE 19880, United States.
Li
L
Zhou
Department of Pediatrics, University of Washington School of Medicine and Division of Emergency Medicine, Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA 98105, United States.
Linda
L
Quan
D002983:Clinical Competence / Q000592:standards*; D003198:Computer Simulation; D003479:Curriculum / Q000592:standards*; D004502:Education, Medical, Continuing / Q000379:methods*; D004521:Educational Measurement; D006801:Humans; D007396:Internship and Residency / Q000379:methods*; D010372:Pediatrics / Q000193:education*; D012151:Resuscitation / Q000193:education*
Graduate medical education; Pediatric resuscitation; Residency curriculum; Simulation; Team assessment