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Repetitive Pediatric Simulation Resuscitation Training

Methods

Data was collected from pediatric and emergency medicine residents participating in high-fidelity (SimBaby, Laerdal Medical, Stavanger, Norway) simulated pediatric resuscitations during their in-patient rotations at Bellevue Hospital Center during the period from April 2008 to April 2009. All house-staff were PALS certified prior to enrollment. All learners went through a simulator orientation prior to any training to gain familiarity with the equipment. Simulated codes occurred in an in-situ simulation room on the Pediatric floor on a bi-weekly basis. Four learners participated in each session lead by two faculty preceptors (Pediatric Emergency Medicine Attending and Fellow). The content for all sessions was developed to reinforce the PALS algorithms. Debriefing involved an open discussion of the performance, faculty feedback, and video review to reinforce knowledge and skills related to the case. Neither the study investigator nor the subjects were blinded to group assignment.

For the first six-months of the study debriefing was conducted using the Standard format. This format involves the learner participating in a simulation case followed by video debriefing and feedback. The facilitator and participants review key points related to pre-defined goals and objectives for the simulation session. This is done through discussion and review of the video recording of the case.

For the second six-months of the study debriefing was conducted using the Repetitive debriefing format. This format involved the learner participating in a 10-minute simulation case followed by video debriefing and feedback. However, the RePedSim format provided the trainees an opportunity to apply the learning points discussed during debriefing by participating in a second 10-minute simulation similar in content to the first case (Figure 1).

At the end of each simulation session participants completed the data collection instrument. The data collection instrument collected demographic information such as training year, prior resuscitation training, prior resuscitation experience, and the time since last PALS training. Participants self reported their knowledge, skills, and attitudes for the session. Data was collected using 5 point likert scales ranging from 1=poor/strongly disagree to 3=fair/neutral to 5=excellent/strongly agree. Demographic variables were compared using chi-squared and ordinal data was compared using a Mann-Whitney U test.

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