• Lilly Bayouth, Sarah Ashley, Jackie Brady, Bryan Lake, Morgan Keeter, David Schiller, Walter C Robey, Stephen Charles, Kari M Beasley, Eric A Toschlog, and Shannon W Longshore.
• Department of Surgery, Brody School of Medicine at East Carolina University, 600 Moye Blvd, Greenville, NC, USA. Electronic address: bayouthl14@ecu.edu.
• J. Pediatr. Surg. 2018 Feb 1; 53 (2): 367-371.

BackgroundOutcome disparities between urban and rural pediatric trauma patients persist, despite regionalization of trauma systems. Rural patients are initially transported to the nearest emergency department (ED), where pediatric care is infrequent. We aim to identify educational intervention targets and increase provider experience via pediatric trauma simulation.MethodsProspective study of simulation-based pediatric trauma resuscitation was performed at three community EDs. Level one trauma center providers facilitated simulations, providing educational feedback. Provider performance comfort and skill with tasks essential to initial trauma care were assessed, comparing pre-/postsimulations. Primary outcomes were: 1) improved comfort performing skills, and 2) team performance during resuscitation.ResultsProvider comfort with the following improved (p-values <0.05): infant airway, infant IV access, blood administration, infant C-spine immobilization, chest tube placement, obtaining radiographic images, initiating transport, and Broselow tape use. The proportion of tasks needing improvement decreased: 42% to 27% (p-value=0.001). Most common deficiencies were: failure to obtain additional history (75%), beginning secondary survey (58.33%), log rolling/examining the back (66.67%), calling for transport (50%), calculating medication dosages (50%).ConclusionsSimulation-based education improves provider comfort and performance. Comparison of patient outcomes to evaluate improvement in pediatric trauma care is warranted.Level Of Evidence RatingIV.Copyright © 2017 Elsevier Inc. All rights reserved.

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