title: Checklist use in evaluating pediatric disaster training.
abstract: OBJECTIVE
  Disaster preparedness training has a small but growing part in medical education. Various strategies have been used to simulate disaster scenarios to safely provide such training. However, a modality to compare their effectiveness is lacking. The authors propose the use of checklists, which have been a standard in aviation safety for decades.
  
  
  METHODS
  Residents at four different academic pediatric residency programs volunteered to participate in tabletop simulation of a timed, pediatric disaster scenario. Resident teams were required to properly triage and manage simulated patients. Care intervention requests corresponding to each of the patients were recorded on a premade checklist.
  
  
  RESULTS
  Thirty-six teams provided a total of 1,476 possible care intervention requests for three pediatric patients: one with crush injury, one with increased intracranial pressure, and a nonverbal child. Some interventions were more likely to be omitted than others, and some teams performed extra interventions. Twenty-five entries from the checklist intervention responses were missing, affecting three of the teams. On average, teams requested 65 percent, were prompted to request 11 percent, and missed 22 percent of all checklist interventions with only 2 percent of all items not being recorded. Chi-square tests were performed for each patient scenario using R software. Categories compared included total counts of "requested," "prompted," and "missed" responses. Chi-square values were all statistically significant (p value < 0.05).
  
  
  CONCLUSIONS
  In the checklist use during a tabletop disaster simulation, the authors have demonstrated that the checklist allows trainees to receive near immediate feedback. This training exercise provided them an opportunity to explore their own preparedness for a disaster scenario in a low-stress environment and allows for evaluation of such preparedness in a safe environment.
authors.affiliation: Children's Hospital Los Angeles, Division of Pediatric Surgery, Keck School of Medicine, University of Southern California, California; Keck School of Medicine, University of Southern California, Los Angeles, California.
authors.forename: Rita V
authors.initials: RV
authors.lastname: Burke
authors.affiliation: Department of Pediatrics, Medical University of South Carolina, South Carolina.
authors.forename: Kathy
authors.initials: K
authors.lastname: Lehman-Huskamp
authors.affiliation: Department of Pediatrics, Section of Emergency Medicine, Yale School of Medicine, Connecticut.
authors.forename: Rachel E
authors.initials: RE
authors.lastname: Whitney
authors.affiliation: Department of Pediatrics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California.
authors.forename: Gitanjli
authors.initials: G
authors.lastname: Arora
authors.affiliation: Department of Pediatrics, Medical University of South Carolina, South Carolina.
authors.forename: Daniel B
authors.initials: DB
authors.lastname: Park
authors.affiliation: Keck School of Medicine, University of Southern California, Los Angeles, California.
authors.forename: Pamela
authors.initials: P
authors.lastname: Mar
authors.affiliation: Department of Pediatrics, Section of Emergency Medicine, Yale School of Medicine, Connecticut.
authors.forename: Mark X
authors.initials: MX
authors.lastname: Cicero
mesh_terms: D057189:Checklist; D054597:Disaster Medicine / Q000193:education*; D004189:Disaster Planning; D004190:Disasters; D006801:Humans; D007396:Internship and Residency; D010372:Pediatrics / Q000193:education*; D000066908:Simulation Training