A Simulation-based Quality Improvement Approach to Improve Pediatric Resident Competency with Required Procedures

Area of Science:

• Medical Education
• Pediatric Training
• Quality Improvement in Healthcare

Background:

• Pediatric residents often graduate lacking confidence and competence in procedural skills.
• Current training programs may need enhanced strategies to address these skill gaps.

Purpose of the Study:

• To evaluate the impact of a procedure simulation boot camp on pediatric residents' self-reported procedural confidence and competence.
• To assess the longitudinal effects of sequential quality improvement interventions on Accreditation Council for Graduate Medical Education Graduating Resident Survey results.

Main Methods:

• Implemented a quality improvement initiative using the Institute for Healthcare Improvement Model for Improvement with three Plan-Do-Study-Act cycles over successive academic years.
• Interventions included increasing awareness of procedural experiences, establishing educational conferences, and a senior resident procedure boot camp.
• Measured senior resident self-reported procedural confidence pre- and post-boot camp and procedural competence via the ACGME Graduating Resident Survey.

Main Results:

• A senior resident procedure boot camp was implemented with high participation rates (88%).
• Resident confidence and competence in procedural skills showed significant improvement post-intervention.
• Accreditation Council for Graduate Medical Education Graduating Resident Survey-reported competency increased notably in key procedures like bag and mask ventilation (77% to 94%) and neonatal endotracheal intubation (39% to 69%).

Conclusions:

• A quality improvement intervention incorporating a procedure simulation boot camp effectively enhanced senior pediatric residents' confidence and competence in ACGME-required procedural skills.
• The use of rapid Plan-Do-Study-Act cycles demonstrated success in improving resident procedural competency.