title: Pediatric anesthesiology fellow education: is a simulation-based boot camp feasible and valuable?
abstract: BACKGROUND
  Pediatric anesthesiologists must manage crises in neonates and children with timely responses and limited margin for error. Teaching the range of relevant skills during a 12-month fellowship is challenging. An experiential simulation-based curriculum can augment acquisition of knowledge and skills.
  
  
  OBJECTIVE
  To develop a simulation-based boot camp (BC) for novice pediatric anesthesiology fellows and assess learner perceptions of BC activities. We hypothesize that BC is feasible, not too basic, and well received by fellows.
  
  
  METHODS
  Skills stations, team-based in situ simulations, and group discussions of complex cases were designed. Stations were evaluated by anonymous survey; fellows rated usefulness in improving knowledge, self-confidence, technical skill, and clinical performance using a Likert scale (1 strongly disagree to 5 strongly agree). They were also asked if stations were too basic or too short. Median and interquartile range (IQR) data were calculated and noted as median (IQR).
  
  
  RESULTS
  Fellows reported the difficult airway station and simulated scenarios improved knowledge, self-confidence, technical skill, and clinical performance. They disagreed that stations were too basic or too short with exception of the difficult airway session, which was too short [4 (4-3)]. Fellows believed the central line station improved knowledge [4 (4-3)], technical skills [4 (4-4)], self-confidence [4 (4-3)], and clinical performance [4 (4-3)]; scores trended toward neutral likely because the station was perceived as too basic [3.5 (4-3)]. An interactive session on epinephrine and intraosseous lines was valued. Complicated case discussion was of educational value [4 (5-4)], the varied opinions of faculty were helpful [4 (5-4)], and the session was neither too basic [2 (2-2)] nor too short [2 (2-2)].
  
  
  CONCLUSIONS
  A simulation-based BC for pediatric anesthesiology fellows was feasible, perceived to improve confidence, knowledge, technical skills, and clinical performance, and was not too basic.
authors.affiliation: Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas, TX, USA.
authors.forename: Aditee P
authors.initials: AP
authors.lastname: Ambardekar
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Perelman School of Medicine at the University of Pennsylvania, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
authors.forename: Devika
authors.initials: D
authors.lastname: Singh
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Perelman School of Medicine at the University of Pennsylvania, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
authors.forename: Justin L
authors.initials: JL
authors.lastname: Lockman
authors.affiliation: Clinical Simulation Center, Milton S. Hershey Medical Center, Hershey, PA, USA.
authors.forename: David L
authors.initials: DL
authors.lastname: Rodgers
authors.affiliation: Center for Simulation, Advanced Education, and Innovation, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
authors.forename: Roberta L
authors.initials: RL
authors.lastname: Hales
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Perelman School of Medicine at the University of Pennsylvania, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
authors.forename: Harshad G
authors.initials: HG
authors.lastname: Gurnaney
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Perelman School of Medicine at the University of Pennsylvania, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
authors.forename: Aruna
authors.initials: A
authors.lastname: Nathan
authors.affiliation: Pennsylvania Patient Safety Authority and ECRI Institute, Harrisburg, PA, USA.|Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
authors.forename: Ellen S
authors.initials: ES
authors.lastname: Deutsch
mesh_terms: D058109:Airway Management; D000776:Anesthesiology / Q000193:education*; D002648:Child; D002675:Child, Preschool; D002983:Clinical Competence; D003479:Curriculum; D004503:Education, Medical, Graduate; D004837:Epinephrine / Q000627:therapeutic use; D005178:Faculty; D005240:Feasibility Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007396:Internship and Residency / Q000379:methods*; D007442:Intubation, Intratracheal; D016544:Patient Simulation; D010372:Pediatrics / Q000193:education*; D014662:Vasoconstrictor Agents / Q000627:therapeutic use
chemical_list: D014662:Vasoconstrictor Agents; D004837:Epinephrine
keywords: education; graduate; leadership; medical; simulation; skills; teamwork