Optimizing Education During Pediatric Resident Mock Code Sessions

Most pediatric residents have limited opportunities to manage cardiac arrest. We used simulation to fill that educational void. Given work hours and other obligations, resident education sessions must be high-yield. We examined the effectiveness of adding varying amounts of formal education to a mock code session on resident knowledge and confidence in managing pediatric cardiac arrest compared with participation alone.

Convenient groups of 3 to 8 pediatric residents completed a simulation session with the identical scenario: a 3-month-old infant with pulseless ventricular tachycardia and then pulseless electrical activity. All residents completed pretests and posttests, which consisted of open-ended knowledge questions from the American Heart Association Pediatric Advanced Life Support guidelines and confidence Likert scale assessments. Resident groups were assigned to 1 of 3 educational models: experiential-only: participation in the mock, traditional: mock code participation with standardized education after the mock code, or reinforced: standardized education before and after mock code participation.

Ninety-five residents participated. Collectively, residents demonstrated a median 2-point (interquartile range, 1-4) increase in knowledge (test maximum score, 10) after they attended a mock code simulation session ( P < 0.0001); however, there were no statistically significant differences noted between educational modalities. All residents also demonstrated a 4-point median increase in confidence (test maximum score, 25) after completing their simulation session (interquartile range, 3-6) ( P < 0.001), but no differences were seen by type or amount of accompanying education.

Residents had gains in confidence and knowledge of pediatric cardiac arrest management after participation in the mock code. Formal educational sessions and reinforced formal education sessions accompanying the mock code did not significantly increase knowledge or confidence.