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In situ pediatric trauma simulation: assessing the impact and feasibility of an interdisciplinary pediatric in situ
Marc Auerbach1, Linda Roney, April Aysseh
1From the *Yale School of Medicine, Yale University, New Haven; †Fairfield University School of Nursing, Fairfield; ‡Pediatric Emergency Department and Pediatric Resource Support Unit, §Pediatric Emergency Department, and ║Pediatric Emergency Medicine, Yale-New Haven Children's Hospital; ¶Adult Trauma Program, Yale-New Haven Hospital; #Yale School of Medicine Section of Pediatric Surgery, Yale-New Haven Children's Hospital; and **Pediatric Emergency Medicine, Yale School of Medicine, New Haven, CT.
Objective:
This study aimed to evaluate the feasibility and measure the impact of an in situ interdisciplinary pediatric trauma quality improvement simulation program.
Methods:
Twenty-two monthly simulations were conducted in a tertiary care pediatric emergency department with the aim of improving the quality of pediatric trauma (February 2010 to November 2012). Each session included 20 minutes of simulated patient care, followed by 30 minutes of debriefing that focused on teamwork, communication, and the identification of gaps in care. A single rater scored the performance of the team in real time using a validated assessment instrument for 6 subcomponents of care (teamwork, airway, intubation, breathing, circulation, and disability). Participants completed a survey and written feedback forms.
Results:
A trend analysis of the 22 simulations found statistically significant positive trends for overall performance, teamwork, and intubation subcomponents; the strength of the upward trend was the strongest for the teamwork (τ = 0.512), followed by overall performance (τ = 0.488) and intubation (τ = 0.433). Two hundred fifty-one of 398 participants completed the participant feedback form (response rate, 63%), reporting that debriefing was the most valuable aspect of the simulation.
Conclusions:
An in situ interdisciplinary pediatric trauma simulation quality improvement program resulted in improved validated trauma simulation assessment scores for overall performance, teamwork, and intubation. Participants reported high levels of satisfaction with the program, and debriefing was reported as the most valuable component of the program.
