Impact and effectiveness of a mandatory competency-based simulation program for pediatric emergency medicine faculty

Area of Science:

• Medical Education
• Emergency Medicine
• Simulation Training

Background:

• Pediatric emergency physicians require continuous skill maintenance for critical procedures and resuscitation.
• Competency-based medical education (CBME) with simulation offers a potential solution for skill upkeep.
• Evaluating a mandatory annual CBME simulation program was essential to assess its effectiveness.

Purpose of the Study:

• To evaluate the effectiveness of a mandatory annual competency-based medical education (CBME) simulation program for pediatric emergency physicians.
• To assess the impact of the program on procedural, point-of-care ultrasound (POCUS), and resuscitation skills.
• To measure the program's effect on team performance during in situ simulations (ISS).

Main Methods:

• A mandatory annual CBME simulation program utilized a flipped-classroom, deliberate practice, mastery-based learning, and stop-pause debriefing approach.
• Participant competence was assessed using a 5-point global rating scale (GRS).
• Team performance in ISS was measured using the Team Emergency Assessment Measure (TEAM) scale, analyzed with statistical process control charts.

Main Results:

• High competence rates were achieved, with physicians succeeding in 97.3% of stations.
• Mean GRS scores indicated mastery or near-mastery across procedural, POCUS, and resuscitation skills.
• Significant improvement was observed in the "followed standards and guidelines" domain of the TEAM scale during ISS, suggesting skills maintenance.

Conclusions:

• The mandatory simulation-based CBME program demonstrated high completion rates and minimal failures.
• The program was highly valued by participants and led to improved or maintained team performance in ISS.
• Time commitment and scheduling were identified as barriers, requiring further attention for program optimization.