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The Simulation-Based Assessment of Pediatric Rapid Response Teams
James J Fehr1, Mary E McBride2, John R Boulet3
1Anesthesiology & Pediatrics, Washington University School of Medicine, St Louis, MO.
The Journal of Pediatrics
|April 25, 2017
Summary
Pediatric rapid response teams (RRTs) trained with simulated decompensating patients showed improved performance. Teams led by intensivists-in-training scored higher, validating simulation as an assessment tool for pediatric critical care teams.
Area of Science:
- Medical Simulation
- Pediatric Critical Care
- Team Training
Background:
- Pediatric rapid response teams (RRTs) require effective training to manage acutely decompensating patients.
- Simulation offers a controlled environment for developing clinical decision-making skills.
Purpose of the Study:
- To develop simulated scenarios for training pediatric RRTs.
- To assess the validity of scenario scores in evaluating RRT performance.
- To compare the performance of RRTs led by intensivists-in-training versus nurse practitioners.
Main Methods:
- Ten simulated scenarios were designed for pediatric RRT training and assessment.
- Pediatric RRTs, including nurses and respiratory therapists, managed simulated patient cases.
- Two raters evaluated performance, and psychometric analyses were conducted.
Main Results:
- RRTs successfully managed common scenarios but struggled with complex cases like aortic coarctation.
- Scenario performance moderately predicted overall team effectiveness.
- Teams led by pediatric intensive care unit (PICU) intensivists-in-training outperformed those led by nurse practitioners.
Conclusions:
- Simulation is a valuable method for enhancing RRT decision-making skills in pediatric critical care.
- The assessment tool demonstrated moderate reliability in scoring team performance.
- Higher scores from intensivist-led teams support the validity of simulation-based assessment.
