title: Spaced scenario demonstrations improve knowledge and confidence in pediatric acute illness management.
abstract: OBJECTIVE
  Nationally accredited simulation courses such as advance pediatric life support and pediatric advance life support are recommended for health care professionals (HCPs) at two yearly intervals as a minimum requirement, despite literature evidence suggesting rapid decline in knowledge shortly after course completion. The objective of this study was to evaluate an observation-based, educational intervention program aimed at improving previously acquired knowledge and confidence in managing critical illnesses.
  
  
  METHODS
  A prospective cohort longitudinal study was conducted over a 6-month period. Participants were assessed with a knowledge based questionnaire immediately prior to and after observing 12 fortnightly critical illness scenario demonstrations (CISDs). The outcome measure was performance on questionnaires. Regression analysis was used to adjust for potential confounders. Questionnaire practice effect was evaluated on 30 independent HCPs not exposed to the CISDs.
  
  
  RESULTS
  Fifty-four HCPs (40 doctors and 14 nurses) participated in the study. All participants had previously attended nationally accredited simulation courses with a mean time since last attendance of 1.8 ± 0.4 years. The median number of attendances at CISD was 6 (2-12). The mean questionnaire scores at baseline (17.2/25) were significantly lower than the mean post intervention questionnaire scores (20.3/25), p = 0.003. The HCPs self-rated confidence in managing CISD was 6.5 times higher at the end of the program in the intervention group (p = 0.002) than at baseline. There was no practice effect for questionnaires demonstrated in the independent sample.
  
  
  CONCLUSIONS
  The educational intervention program significantly improved the knowledge and confidence of the participants in managing pediatric critical illnesses. The CISD program provides an inexpensive, practical, and time effective method of facilitating knowledge acquisition and retention. Despite the distinctively different approach, this study has shown the effectiveness of the participant being an observer to enhance pediatric resuscitation skills.
authors.affiliation: Sydney Medical School-Nepean, The University of Sydney , Sydney, NSW , Australia ; Schulich School of Medicine and Dentistry, University of Western Ontario , London, ON , Canada.
authors.forename: Rahul
authors.initials: R
authors.lastname: Ojha
authors.affiliation: Sydney Medical School-Nepean, The University of Sydney , Sydney, NSW , Australia.
authors.forename: Anthony
authors.initials: A
authors.lastname: Liu
authors.affiliation: Sydney Medical School-Nepean, The University of Sydney , Sydney, NSW , Australia.
authors.forename: Bernard Linton
authors.initials: BL
authors.lastname: Champion
authors.affiliation: Sydney Medical School-Nepean, The University of Sydney , Sydney, NSW , Australia.
authors.forename: Emily
authors.initials: E
authors.lastname: Hibbert
authors.affiliation: Sydney Medical School-Nepean, The University of Sydney , Sydney, NSW , Australia.
authors.forename: Ralph Kay Heinrich
authors.initials: RK
authors.lastname: Nanan
keywords: knowledge retention; medical education; simulation; spaced education