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Simulation-Based Emergency Team Training in Pediatrics: A Systematic Review
Signe Thim1, Tine Brink Henriksen1, Henrik Laursen2
1Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark.
Insights
Pediatric simulation-based team training enhances clinical performance in critical pediatric emergencies. While survival benefits are suggested, further research is needed due to study limitations.
Area of Science:
- Medical Education
- Pediatric Emergency Medicine
- Team Training
Background:
- Critically ill children present unique challenges to emergency care teams.
- Simulation-based team training is explored for preparedness, but evidence needs synthesis.
Purpose of the Study:
- To systematically review the effects of simulation-based team training on clinical performance and patient outcomes in pediatric emergency settings.
Main Methods:
- Systematic review of studies from multiple databases (MEDLINE, Embase, CINAHL, Cochrane Library).
- Included studies focused on pediatric emergency settings with reported clinical performance and patient outcomes.
- Data extraction and risk of bias assessment using established tools.
Main Results:
- 79 studies were included, with 15 reporting relevant outcomes.
- Improvements in team performance, adherence to guidelines, and time-critical task management were observed.
- Randomized studies showed improved performance 2-6 months post-intervention; meta-analysis was not possible.
Conclusions:
- Pediatric simulation-based team training positively impacts clinical performance and guideline adherence.
- Evidence suggests potential survival benefits, though high risk of bias necessitates caution.
- Skills and team performance show improvement for 2-6 months, highlighting the need for long-term outcome research.
Objectives:
The rare event of handling critically ill children often challenge the emergency care team. Several studies have investigated effects of simulation-based team training to prepare for such events, but the body of evidence remains to be compiled. We performed a systematic review of the effects of simulation-based team training on clinical performance and patient outcome.
Methods:
From a search of MEDLINE, Embase, CINAHL, and Cochrane Library, we included studies of team training in emergency pediatric settings with reported clinical performance and patient outcomes. We extracted data using a predefined template and assessed risk of bias using the Cochrane risk-of-bias tool for randomized trials 2.0 and the Newcastle Ottawa Quality Assessment Scale.
Results:
We screened 1926 abstracts and included 79 studies. We identified 15 studies reporting clinical health care professional performance or patient outcomes. Four studies reported survival data, 5 reported time-critical clinical events, 5 reported adherence to guidelines, checklists or tasks, and 2 reported on airway management. Randomized studies revealed improved team performance in simulated reevaluations 2 to 6 months after intervention. A meta-analysis was impossible because of heterogeneous interventions and outcomes. Most included studies had significant methodological limitations.
Conclusions:
Pediatric simulation-based team training improves clinical performance in time-critical tasks and adherence to guidelines. Improved survival was indicated but not concluded because of high risk of bias. Team performance and technical skills improved for at least 2 to 6 months. Future research should include longer-term measures of skill retention and patient outcomes or clinical measures of treatment quality whenever possible.
