The Effectiveness of Remote Facilitation in Simulation-Based Pediatric Resuscitation Training for Medical Students.
OBJECTIVE
To assess the effectiveness of pediatric simulation by remote facilitation. We hypothesized that simulation by remote facilitation is more effective compared to simulation by an on-site facilitator. We defined remote facilitation as a facilitator remotely (1) introduces simulation-based learning and simulation environment, (2) runs scenarios, and (3) performs debriefing with an on-site facilitator.


METHODS
A remote simulation program for medical students during pediatric rotation was implemented. Groups were allocated to either remote or on-site facilitation depending on the availability of telemedicine technology. Both groups had identical 1-hour simulation sessions with 2 scenarios and debriefing. Their team performance was assessed with behavioral assessment tool by a trained rater. Perception by students was evaluated with Likert scale (1-7).


RESULTS
Fifteen groups with 89 students participated in a simulation by remote facilitation, and 8 groups with 47 students participated in a simulation by on-site facilitation. Participant demographics and previous simulation experience were similar. Both groups improved their performance from first to second scenario: groups by remote simulation (first [8.5 ± 4.2] vs second [13.2 ± 6.2], P = 0.003), and groups by on-site simulation (first [6.9 ± 4.1] vs second [12.4 ± 6.4], P = 0.056). The performance improvement was not significantly different between the 2 groups (P = 0.94). Faculty evaluation by students was equally high in both groups (7 vs 7; P = 0.65).


CONCLUSIONS
A pediatric acute care simulation by remote facilitation significantly improved students' performance. In this pilot study, remote facilitation seems as effective as a traditional, locally facilitated simulation. The remote simulation can be a strong alternative method, especially where experienced facilitators are limited.
From the *Department of Pediatrics, School of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan; †Paediatric Intensive Care Unit, Royal Children's Hospital, Melbourne, Australia; ‡Center for Simulation, Advanced Education and Innovation, The Children's Hospital of Philadelphia, Philadelphia PA; §Division of Critical Care Medicine, Aichi Children's Health and Medical Center, Aichi, Japan; ∥Department of IS Client Services, The Children's Hospital of Philadelphia, Philadelphia, PA; ¶Department of IS Network Support, The Children's Hospital of Philadelphia, Philadelphia, PA; and #Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA.
Kunio
K
Ohta
Hiroshi
H
Kurosawa
Yuko
Y
Shiima
Takanari
T
Ikeyama
James
J
Scott
Scott
S
Hayes
Michael
M
Gould
Newton
N
Buchanan
Vinay
V
Nadkarni
Akira
A
Nishisaki
D000328:Adult; D016887:Cardiopulmonary Resuscitation / Q000193:education*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D010372:Pediatrics / Q000193:education*; D010865:Pilot Projects; D000066908:Simulation Training / Q000379:methods*; D013337:Students, Medical; D055815:Young Adult