title: Pediatric crisis resource management training improves emergency medicine trainees' perceived ability to manage emergencies and ability to identify teamwork errors.
abstract: OBJECTIVE
  Improved pediatric crisis resource management (CRM) training is needed in emergency medicine residencies because of the variable nature of exposure to critically ill pediatric patients during training. We created a short, needs-based pediatric CRM simulation workshop with postactivity follow-up to determine retention of CRM knowledge. Our aims were to provide a realistic learning experience for residents and to help the learners recognize common errors in teamwork and improve their perceived abilities to manage ill pediatric patients.
  
  
  METHODS
  Residents participated in a 4-hour objectives-based workshop derived from a formal needs assessment. To quantify their subjective abilities to manage pediatric cases, the residents completed a postworkshop survey (with a retrospective precomponent to assess perceived change). Ability to identify CRM errors was determined via a written assessment of scripted errors in a prerecorded video observed before and 1 month after completion of the workshop.
  
  
  RESULTS
  Fifteen of the 16 eligible emergency medicine residents (postgraduate year 1-5) attended the workshop and completed the surveys. There were significant differences in 15 of 16 retrospective pre to post survey items using the Wilcoxon rank sum test for non-parametric data. These included ability to be an effective team leader in general (P < 0.008), delegating tasks appropriately (P < 0.009), and ability to ensure closed-loop communication (P < 0.008). There was a significant improvement in identification of CRM errors through the use of the video assessment from 3 of the 12 CRM errors to 7 of the 12 CRM errors (P < 0.006).
  
  
  CONCLUSIONS
  The pediatric CRM simulation-based workshop improved the residents' self-perceptions of their pediatric CRM abilities and improved their performance on a video assessment task.
authors.affiliation: From the *Division of Pediatric Emergency Medicine, †Arnold and Blema Steinberg Medical Simulation Center, ‡Center for Medical Education, §Division of General Internal Medicine, and ∥Department of Pediatrics, McGill University, Montreal, Quebec, Canada.
authors.forename: Ilana
authors.initials: I
authors.lastname: Bank
authors.forename: Linda
authors.initials: L
authors.lastname: Snell
authors.forename: Farhan
authors.initials: F
authors.lastname: Bhanji
mesh_terms: D002675:Child, Preschool; D003198:Computer Simulation; D004501:Education, Medical / Q000379:methods*; D004635:Emergency Medicine / Q000193:education*; D005260:Female; D015276:Health Care Rationing / Q000379:methods*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007318:Inservice Training; D007396:Internship and Residency / Q000379:methods; D008297:Male; D020380:Needs Assessment; D010348:Patient Care Team / Q000458:organization & administration*; D012151:Resuscitation / Q000193:education