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Repetitive simulation is an effective instructional design within a pediatric resident simulation curriculum
Selin Tuysuzoglu Sagalowsky1, Kimball A Prentiss2, Robert J Vinci3
1Departments of Emergency Medicine and Pediatrics, Columbia University College of Physicians and Surgeons, NewYork-Presbyterian Morgan Stanley Children's Hospital, New York, New York, USA.
Introduction:
Repetitive paediatric simulation (scenario-debrief-scenario; RPS) is an instructional design that allows immediate application of learner-directed feedback, in contrast to standard simulation (scenario-debrief; STN). Our aim was to examine the impact of RPS embedded within a paediatric resident simulation curriculum, comparing it to STN.
Methods:
In this prospective educational cohort study, paediatric residents were enrolled in STN (n=18) or RPS (n=15) groups from August 2012 through June 2013. Each group performed an initial high-fidelity simulation and another after 1-2 weeks. Attitudes, confidence and knowledge were assessed using anonymous surveys with each scenario and at 4-6 months. Skills were assessed in real time with a modified Tool for Resuscitation Assessment Using Computerised Simulation (TRACS). Two blinded reviewers assessed a subset of videotaped scenarios for TRACS inter-rater reliability.
Results:
Both STN and RPS designs were rated highly. The curriculum led to significant short-term and long-term improvements in confidence, knowledge and performance, with no significant differences between groups. All final respondents reported that they would prefer RPS to STN (n=6 STN, 4 RPS). TRACS intraclass correlation was 0.87 among all reviewers.
Conclusions:
Paediatric residents reported preference for RPS over STN, with comparable impacts on confidence, knowledge and performance. The modified TRACS was a reliable tool to assess individual resident performance. Further research is needed to determine whether RPS is a more effective instructional design for teaching resuscitation skills to paediatric residents.
