• Kunio Ohta, Hiroshi Kurosawa, Yuko Shiima, Takanari Ikeyama, James Scott, Scott Hayes, Michael Gould, Newton Buchanan, Vinay Nadkarni, and Akira Nishisaki.
• From the *Department of Pediatrics, School of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan; †Paediatric Intensive Care Unit, Royal Children's Hospital, Melbourne, Australia; ‡Center for Simulation, Advanced Education and Innovation, The Children's Hospital of Philadelphia, Philadelphia PA; §Division of Critical Care Medicine, Aichi Children's Health and Medical Center, Aichi, Japan; ∥Department of IS Client Services, The Children's Hospital of Philadelphia, Philadelphia, PA; ¶Department of IS Network Support, The Children's Hospital of Philadelphia, Philadelphia, PA; and #Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA.
• Pediatr Emerg Care. 2017 Aug 1; 33 (8): 564-569.

ObjectivesTo assess the effectiveness of pediatric simulation by remote facilitation. We hypothesized that simulation by remote facilitation is more effective compared to simulation by an on-site facilitator. We defined remote facilitation as a facilitator remotely (1) introduces simulation-based learning and simulation environment, (2) runs scenarios, and (3) performs debriefing with an on-site facilitator.MethodsA remote simulation program for medical students during pediatric rotation was implemented. Groups were allocated to either remote or on-site facilitation depending on the availability of telemedicine technology. Both groups had identical 1-hour simulation sessions with 2 scenarios and debriefing. Their team performance was assessed with behavioral assessment tool by a trained rater. Perception by students was evaluated with Likert scale (1-7).ResultsFifteen groups with 89 students participated in a simulation by remote facilitation, and 8 groups with 47 students participated in a simulation by on-site facilitation. Participant demographics and previous simulation experience were similar. Both groups improved their performance from first to second scenario: groups by remote simulation (first [8.5 ± 4.2] vs second [13.2 ± 6.2], P = 0.003), and groups by on-site simulation (first [6.9 ± 4.1] vs second [12.4 ± 6.4], P = 0.056). The performance improvement was not significantly different between the 2 groups (P = 0.94). Faculty evaluation by students was equally high in both groups (7 vs 7; P = 0.65).ConclusionsA pediatric acute care simulation by remote facilitation significantly improved students' performance. In this pilot study, remote facilitation seems as effective as a traditional, locally facilitated simulation. The remote simulation can be a strong alternative method, especially where experienced facilitators are limited.

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