122 - Creation and Evaluation of a Simulation-Based Training Curriculum for Pediatric Interns: Assessing an Acutely Ill Hospitalized Child

Poster Number: 122
Publication Number: 122.2886

Background: Interns are often the first physicians to respond to acutely decompensating hospitalized patients before more experienced providers arrive. A core set of clinical skills is needed. It is essential to have educational exposure to various scenarios prior to being a supervising resident, and specific clinical experiences may vary. Simulation (sim) offers a safe educational environment, with repeated reinforcement sessions needed for retention of skills and comfort level.

Objective: A longitudinal, sim-based curriculum of hands-on, practical education in the initial assessment and management of an acutely ill child will improve interns’ knowledge and resuscitation procedural skill competency.

Design/Methods: This year-long, prospective, observational study evaluated interns using a sim-based skill assessment. An anonymous survey (blinded code name) collected prior experience, beliefs, and medical knowledge. Each intern rotated through 3 objective skill stations (bag-mask ventilation and set-up/knowledge of oxygen delivery devices). Individual clinical scenarios using high-fidelity simulators evaluated knowledge and resuscitation skills (timeliness/thoroughness of assessment, communication, clinical reasoning, escalation of care). Group sim sessions were repeated during the year. Survey and skill station assessments were repeated midway and at the end of the first training year. Data include survey results and direct observation checklists for objective and initial assessment skills. To account for maturation effect, data were collected from the post-graduate year 2 (PGY2) residents, who did not participate in the sim sessions, at the end of their first year, and from senior residents and attendings.

Results: Eight interns participated, and 8 PGY2s in the control group. Survey data included 8 senior residents and 19 attendings. Intern confidence levels, skill competency and medical knowledge performance were significantly different pre-, mid-, and post-curriculum (table 1). Skill competency and medical knowledge performances were significantly different between interns and control group, with no difference in confidence levels (table 2).

Conclusion(s): Interns’ knowledge and skill competency improved after the curriculum, controlled for maturation effect. Confidence levels improved, though no difference with controls. The course was well received and rated nonjudgmental, safe, and effective. Residencies should consider adding sim-based skill training into the curriculum. Limitations include small sample size. Future studies will evaluate the application of skills learned to patient care and outcomes.