title: Effectiveness of a High-Fidelity Simulation-Based Training Program in Managing Cardiac Arrhythmias in Children: A Randomized Pilot Study.
abstract: OBJECTIVE
  Pediatric cardiac arrest is a rare event. Its management requires technical (TSs) and nontechnical skills (NTSs). We assessed the effectiveness of a simulation-based training to improve these skills in managing life-threatening pediatric cardiac arrhythmias.
  
  
  METHODS
  Four teams, each composed of 1 pediatric resident, 1 emergency medicine resident, and 2 pediatric nurses, were randomly assigned to the experimental group (EG) participating in 5 video-recorded simulation sessions with debriefing or to the control group (CG) assessed 2 times with video-recorded simulation sessions without debriefing at a 2-week interval. Questionnaires assessed self-reported changes in self-efficacy, stress, and satisfaction about skills. Blinded evaluators assessed changes in leaders' TSs and NTSs during the simulations and the time to initiate cardiopulmonary resuscitation.
  
  
  RESULTS
  After training, stress decreased and satisfaction about skills increased in the EG, whereas it remained the same in the CG (P = 0.014 and P < 0.001, respectively). There was no significant change in self-efficacy. Analyses of video-recorded skills showed significant improvements in TSs and NTSs of the EG leaders after training, but not of the CG leaders (P = 0.026, P = 0.038, respectively). The comparison of the evolution of the 2 groups concerning time to initiate cardiopulmonary resuscitation was not significantly different between the first and last simulation sessions.
  
  
  CONCLUSIONS
  A simulation-based training with debriefing had positive effects on stress and satisfaction about skills of pediatric residents and nurses and on observed TSs and NTSs of the leaders during simulation sessions. A future study should assess the effectiveness of this training in a larger sample and its impact on skills during actual emergencies.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Bragard
authors.affiliation: Department of Paediatrics, University Hospital of Liège, Liège, Belgium.
authors.forename: Nesrine
authors.initials: N
authors.lastname: Farhat
authors.affiliation: Department of Paediatrics, University Hospital of Liège, Liège, Belgium.
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Seghaye
authors.affiliation: Department of Paediatrics, University Hospital of Geneva, Geneva, Switzerland.
authors.forename: Oliver
authors.initials: O
authors.lastname: Karam
authors.affiliation: Department of Anaesthesiology and Intensive Care Medicine, Hôpital Européen Georges Pompidou, Paris, France.
authors.forename: Arthur
authors.initials: A
authors.lastname: Neuschwander
authors.affiliation: Department of Paediatrics, University Hospital Sainte Justine, Montreal, Quebec, Canada.
authors.forename: Yasaman
authors.initials: Y
authors.lastname: Shayan
authors.affiliation: Department of Paediatrics, University Hospital of Liège, Liège, Belgium.
authors.forename: Katharina
authors.initials: K
authors.lastname: Schumacher
mesh_terms: D001145:Arrhythmias, Cardiac / Q000628:therapy*; D016887:Cardiopulmonary Resuscitation; D002648:Child; D002983:Clinical Competence; D019468:Disease Management; D004636:Emergency Service, Hospital; D000070856:High Fidelity Simulation Training / Q000379:methods*; D006801:Humans; D007396:Internship and Residency; D000072222:Nurses, Pediatric / Q000523:psychology*; D000072143:Pediatricians / Q000523:psychology*; D010865:Pilot Projects; D011897:Random Allocation; D020377:Self Efficacy; D057566:Self Report; D014741:Video Recording