Closing the Trauma Performance Improvement Loop With In-situ Simulation

Area of Science:

• Medical Education
• Trauma Care
• Simulation-Based Learning

Background:

• Continuous performance improvement (PI) is vital for optimal trauma care.
• An in-situ simulation-based medical education curriculum was developed using PI findings.
• This study explored the effectiveness of pediatric trauma simulations for PI issues.

Purpose of the Study:

• To evaluate the efficacy of high-fidelity pediatric trauma simulations.
• To improve self-reported provider comfort and knowledge regarding identified trauma PI issues.

Main Methods:

• The study was conducted at a Level I Pediatric Trauma Center.
• Clinical issues identified through trauma PI (e.g., elevated intracranial pressure, massive transfusion protocol) were integrated into simulations.
• High-fidelity in-situ trauma mock codes were performed, followed by debriefing and pre/post-simulation surveys.

Main Results:

• Twenty-three providers participated in the simulations.
• Self-reported provider confidence significantly improved post-simulation (P=0.02).
• Trauma experience and knowledge scores increased from 82% to 93% (P=0.02).

Conclusions:

• High-fidelity pediatric trauma simulations effectively enhance provider comfort, knowledge, and experience.
• Integrating simulations into PI processes reinforces provider education in a controlled environment.
• Further research is needed to assess the impact of simulations on clinical pathways and patient outcomes.