title: Improved Team Performance During Pediatric Resuscitations After Rapid Cycle Deliberate Practice Compared With Traditional Debriefing: A Pilot Study.
abstract: BACKGROUND
  Simulation-based medical education (SBME) improves medical knowledge compared with no intervention. In traditional SBME, more time is spent debriefing than practicing skills. Rapid cycle deliberate practice (RCDP) simulation allows learners to practice skills repetitively, receive brief interspersed feedback, and has been shown to improve individual performance of resuscitation skills in simulation; it has not been compared with traditional simulation methods.
  
  
  OBJECTIVE
  The aim of the study was to compare traditional and RCDP SBME.
  
  
  METHODS
  Four pediatric resuscitation cases (3 for teaching and 1 for testing) were developed. For the RCDP arm, traditional cases were deconstructed into sequences of progressively difficult rounds. The last RCDP round served as the traditional arm scenario.Learners received 1 type of instruction on 2 separate days. Pretest and posttest performance during simulation were video recorded and scored using the Simulation Team Assessment Tool; satisfaction surveys were collected.
  
  
  RESULTS
  Pretest team performance was similar in both groups. Simulation Team Assessment Tool score improvement for RCDP was 7.2% (95% confidence interval, 3.4% to 11%) and traditional was 0.8% (95% confidence interval, -11% to 13%). The difference in improvement of the human factors subscore was statistically significant; RCDP improved 10.2% and traditional improved 1.7% (P = 0.013). The RCDP technique was well received by learners but caused fatigue.
  
  
  CONCLUSIONS
  This pilot study showed a trend toward greater improvement in team performance and significantly greater improvement for human factors with RCDP compared with traditional simulation. Future studies comparing RCDP with other methods are needed to identify best practices and applications of RCDP, including which learners and learning objectives are best suited to RCDP.
authors.affiliation: From the Department of Pediatrics, Section of Emergency Medicine, Baylor College of Medicine, Houston, TX.
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Lemke
authors.forename: Elaine K
authors.initials: EK
authors.lastname: Fielder
authors.forename: Deborah C
authors.initials: DC
authors.lastname: Hsu
authors.forename: Cara B
authors.initials: CB
authors.lastname: Doughty
mesh_terms: D002983:Clinical Competence; D003479:Curriculum; D006801:Humans; D010348:Patient Care Team; D010865:Pilot Projects; D012151:Resuscitation / Q000193:education*; D000066908:Simulation Training