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Effectiveness of a High-Fidelity Simulation-Based Training Program in Managing Cardiac Arrhythmias in Children: A
Isabelle Bragard, Nesrine Farhat1, Marie-Christine Seghaye1
1Department of Paediatrics, University Hospital of Liège, Liège, Belgium.
Insights
Simulation training with debriefing improved technical and nontechnical skills for pediatric cardiac arrest management. This approach reduced stress and increased satisfaction among pediatric residents and nurses.
Area of Science:
- Medical Education
- Pediatric Emergency Medicine
- Cardiovascular Research
Background:
- Pediatric cardiac arrest management demands proficiency in both technical skills (TSs) and nontechnical skills (NTSs).
- Simulation-based training offers a controlled environment to hone these critical skills.
Purpose of the Study:
- To evaluate the efficacy of simulation-based training incorporating debriefing for enhancing TSs and NTSs in pediatric cardiac arrhythmia management.
- To assess the impact of this training on self-efficacy, stress, and satisfaction levels of healthcare professionals.
Main Methods:
- Four teams, each with a pediatric resident, an emergency medicine resident, and two pediatric nurses, were randomized into an experimental group (EG) and a control group (CG).
- The EG underwent five video-recorded simulation sessions with debriefing, while the CG had two sessions without debriefing over two weeks.
- Self-reported changes in self-efficacy, stress, and satisfaction were assessed via questionnaires, alongside blinded evaluation of leaders' TSs, NTSs, and time to initiate cardiopulmonary resuscitation.
Main Results:
- The EG demonstrated significant reductions in stress and increases in satisfaction post-training (P = 0.014 and P < 0.001, respectively), unlike the CG.
- Blinded assessments revealed significant improvements in leaders' TSs and NTSs in the EG (P = 0.026, P = 0.038, respectively), with no significant changes observed in the CG.
- No significant difference was found in the time to initiate cardiopulmonary resuscitation between the groups' initial and final simulations.
Conclusions:
- Simulation-based training with debriefing positively impacts stress levels, skill satisfaction, and observed technical and nontechnical skills in pediatric residents and nurses during simulated emergencies.
- Further research with larger sample sizes is warranted to confirm these findings and evaluate the training's effectiveness in real-world emergency scenarios.
Objectives:
Pediatric cardiac arrest is a rare event. Its management requires technical (TSs) and nontechnical skills (NTSs). We assessed the effectiveness of a simulation-based training to improve these skills in managing life-threatening pediatric cardiac arrhythmias.
Methods:
Four teams, each composed of 1 pediatric resident, 1 emergency medicine resident, and 2 pediatric nurses, were randomly assigned to the experimental group (EG) participating in 5 video-recorded simulation sessions with debriefing or to the control group (CG) assessed 2 times with video-recorded simulation sessions without debriefing at a 2-week interval. Questionnaires assessed self-reported changes in self-efficacy, stress, and satisfaction about skills. Blinded evaluators assessed changes in leaders' TSs and NTSs during the simulations and the time to initiate cardiopulmonary resuscitation.
Results:
After training, stress decreased and satisfaction about skills increased in the EG, whereas it remained the same in the CG (P = 0.014 and P < 0.001, respectively). There was no significant change in self-efficacy. Analyses of video-recorded skills showed significant improvements in TSs and NTSs of the EG leaders after training, but not of the CG leaders (P = 0.026, P = 0.038, respectively). The comparison of the evolution of the 2 groups concerning time to initiate cardiopulmonary resuscitation was not significantly different between the first and last simulation sessions.
Conclusions:
A simulation-based training with debriefing had positive effects on stress and satisfaction about skills of pediatric residents and nurses and on observed TSs and NTSs of the leaders during simulation sessions. A future study should assess the effectiveness of this training in a larger sample and its impact on skills during actual emergencies.
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