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Bronchiolitis Simulation Module in the Pediatric Preclerkship Educational Exercises (PRECEDE) Curriculum
Justin M Jeffers1, Amit Pahwa2, Stacy Cooper3
1Assistant Professor, Department of Pediatrics, Johns Hopkins University School of Medicine; Adjunct Faculty, Johns Hopkins University School of Education.
Insights
Pediatric medical students significantly improved their management of infant respiratory distress from acute bronchiolitis after simulation training. Further simulation opportunities are recommended for enhanced clinical skills development.
Area of Science:
- Pediatric Emergency Medicine
- Medical Simulation
- Respiratory Illness
Background:
- Acute bronchiolitis affects 90% of children under 2, causing 200,000 deaths annually.
- Current management focuses on respiratory support and prevention.
- Effective assessment and escalation of care are crucial for healthcare providers.
Purpose of the Study:
- To evaluate the impact of high-fidelity simulation on pediatric clerkship students' management of respiratory distress in acute bronchiolitis.
- To assess performance improvement after simulation-based training and debriefing.
Main Methods:
- A high-fidelity infant simulator was used to model progressing respiratory distress in acute bronchiolitis.
- Pediatric clerkship students underwent simulation, followed by debriefing and repeat simulation.
- Performance was measured using a weighted checklist, and student feedback was collected.
Main Results:
- Student performance improved significantly from 57% to 86% (p < .05) after simulation and debriefing.
- Donning personal protective equipment was the most common missed item pre- and post-simulation.
- The simulation course was well-received, with requests for more opportunities.
Conclusions:
- Simulation-based training effectively improved pediatric students' management of respiratory distress in acute bronchiolitis.
- Performance-based assessment tools can provide valid evidence of learning.
- Increased simulation opportunities and faculty diversity are recommended for future training.
Introduction:
Acute bronchiolitis is a viral infection infecting 90% of children under the age of 2 years, with approximately 200,000 deaths per year. The current standard of care remains largely respiratory support and prevention. Therefore, understanding how to assess and escalate respiratory supportive care is paramount for health care providers taking care of children.
Methods:
We used a high-fidelity simulator to simulate an infant with progressing respiratory distress in the setting of acute bronchiolitis. The participants were pediatric clerkship medical students during their preclerkship educational exercises (PRECEDE). The students were asked to evaluate and treat the simulated patient. After debriefing, the students repeated the simulation. We assessed both performances via a weighted checklist specifically developed for this case to measure team performance. Students also completed an overall course evaluation.
Results:
Ninety out of 121 pediatric clerkship students were enrolled. Performance improved from 57% to 86% ( p < .05). Donning appropriate personal protection equipment was the most missed item both pre- and postdebriefing. Overall, the course was well liked and received. Participants requested more simulation opportunities within PRECEDE as well as a summary document to reinforce learning.
Discussion:
Pediatric clerkship students improved their performance managing progressing respiratory distress due to acute bronchiolitis via a performance-based assessment tool with sound validity evidence. Improvements going forward include improving faculty diversity and offering more simulation opportunities.
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