• Akira Nishisaki, Roberta Hales, Katherine Biagas, Ira Cheifetz, Christine Corriveau, Nan Garber, Elizabeth Hunt, Rima Jarrah, John McCloskey, Wynne Morrison, Kristen Nelson, Dana Niles, Sophia Smith, Samuel Thomas, Stephanie Tuttle, Mark Helfaer, and Vinay Nadkarni.
• Anesthesiology and Critical Care Medicine, Center for Simulation, The Children's Hospital of Philadelphia, PA, USA. nishisaki@email.chop.edu
• Pediatr Crit Care Me. 2009 Mar 1;10(2):157-62.

ObjectiveSimulation training has been used to integrate didactic knowledge, technical skills, and crisis resource management for effective orientation and patient safety. We hypothesize multi-institutional simulation-based training for first year pediatric critical care (PCC) fellows is feasible and effective.DesignDescriptive, educational intervention study.SettingThe simulation facility at the host institution.InterventionsA multicentered simulation-based orientation training "boot camp" for first year PCC fellows was held at a large simulation center. Immediate posttraining evaluation and 6-month follow-up surveys were distributed to participants.Measurements And Main ResultsA novel simulation-based orientation training for first year PCC fellows was facilitated by volunteer faculty from seven institutions. The two and a half day course was organized to cover common PCC crises. High-fidelity simulation was integrated into each session (airway management, vascular access, resuscitation, sepsis, trauma/traumatic brain injury, delivering bad news). Twenty-two first year PCC fellows from nine fellowship programs attended, and 13 faculty facilitated, for a total of 15.5 hours (369 person-hours) of training. This consisted of 2.75 hours for whole group didactic sessions (17.7%), 1.08 hours for a small group interactive session (7.0%), 4.67 hours for task training (30.1%), and 7 hours for training (45.2%) with high-fidelity simulation and crisis resource management. A "train to success" approach with repetitive practice of critical assessment and interventional skills yielded higher scores in training effectiveness in the end-of-course evaluation. A follow-up survey revealed this training was highly effective in improving clinical performance and self-confidence.ConclusionsThe first PCC orientation training integrated with simulation was effective and logistically feasible. The train to success concept with repetitive practice was highly valued by participants. Continuation and expansion of this novel multi-institutional training is planned.

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