Rapid cycle deliberate practice vs. traditional simulation in a resource-limited setting.

Area of Science:

• Medical Education
• Simulation-Based Training
• Pediatric Resuscitation

Background:

• Developing effective simulation-based curricula for pediatric residents in resource-limited settings is crucial.
• Comparing novel teaching methods like rapid cycle deliberate practice (RCDP) with traditional approaches is essential for optimizing training.
• Assessing the impact on both clinical performance and resident confidence is key to evaluating educational interventions.

Purpose of the Study:

• To develop and evaluate a low-fidelity simulation-based curriculum for pediatric residents in Rwanda.
• To compare the effectiveness of RCDP versus traditional debriefing in improving simulation-based performance.
• To determine if RCDP enhances resident confidence more than traditional debriefing.

Main Methods:

• A 6-month low-fidelity simulation curriculum was implemented for pediatric residents at CHUK.
• Participants were randomized to either RCDP or traditional simulation debriefing groups.
• Performance was assessed pre- and post-curriculum using the Simulation Team Assessment Tool (STAT), and self-confidence was measured via Likert scale surveys.

Main Results:

• Both RCDP and traditional groups showed a significant 21% increase in performance (p < 0.001), with no significant difference between the groups (p=0.94).
• Inter-rater reliability for performance assessment was exceptional (ICC ≥ 0.95).
• Overall self-confidence scores improved significantly (p < 0.001), but without a significant difference between the RCDP and traditional groups.

Conclusions:

• A 6-month low-fidelity simulation curriculum effectively improved pediatric residents' resuscitation performance in Rwanda.
• Both RCDP and traditional simulation debriefing are valuable for enhancing resuscitation skills in resource-limited settings.
• Neither method demonstrated superiority in improving performance or confidence, suggesting flexibility in implementation.