• Mark C Dugan, Courtney E McCracken, and Kiran B Hebbar.
• 1Division of Pediatric Critical Care, Children's Hospital of Nevada at UMC, Las Vegas, NV. 2Department of Pediatrics, University of Nevada School of Medicine, Las Vegas, NV. 3Department of Pediatrics, Emory University School of Medicine, Atlanta, GA. 4Division of Pediatric Critical Care, Emory University School of Medicine, Atlanta, GA. 5Division of Pediatric Critical Care, Children's Healthcare of Atlanta, Atlanta, GA.
• Pediatr Crit Care Me. 2016 Jul 1; 17 (7): 605-14.

ObjectivesDetermine whether serial simulation training sessions improve resident recognition and initial septic shock management in a critically ill simulated septic shock patient, and to determine whether serial simulations further improve resident task performance when compared with a single simulation session.DesignProspective observational cohort study with a live expert review of trainee simulation performance. Expert reviewers blinded to prior trainee performance.SettingA PICU room in a quaternary-care children's hospital, featuring a hi-fidelity pediatric patient simulator.SubjectsPostgraduate year-2 and postgraduate year-3 pediatric residents who rotate through the PICU.InterventionsPostgraduate year-3 residents as the control cohort, completing one simulation near the start of their third residency year. Postgraduate year-2 residents as the intervention cohort, completing two simulations during their second residency year and one near the start of their third residency year.Measurements And Main ResultsResident objective performance was measured using a validated 27-item checklist (graded 0/1) related to monitoring, data gathering, and interventions in the diagnosis and management of pediatric septic shock. The intervention cohort had a higher mean performance percentage score during their third simulation than the control cohort completing their single simulation (87% vs 77%; p < 0.001). Septic shock was correctly diagnosed more often in the intervention cohort at the time of their third simulation (100% vs 78%; p < 0.001). Appropriate broad-spectrum antibiotics were administered correctly more often in the intervention cohort (83% vs 50%; p < 0.001).ConclusionsSimulations significantly improved resident performance scores in the management of septic shock with repetitive simulation showing significant ongoing improvements. Further studies are needed to determine long-term impact on knowledge and skill retention and whether results attained in a simulation environment are translatable into clinical practice in improving bedside care.

16 keywords...

hide…