Breathing easy: A qualitative analysis of caregiver experience with high-fidelity pediatric tracheostomy simulation

Caregivers of children with tracheostomies require comprehensive education to safely care for their child at home. High-fidelity simulation has been shown to increase confidence and competence in tracheostomy emergencies, but little is known of how caregivers perceive and engage with this method. This study explores the perspectives of caregivers learning tracheostomy emergency management skills through high-fidelity simulation using Kolb's experiential learning theory (KLT) as a framework.

A qualitative descriptive study was conducted using semi-structured interviews of 21 caregivers after high-fidelity simulation training and prior to their first discharge home from a pediatric hospital. Themes and subthemes aligning with KLT emerged through thematic analysis.

High-fidelity simulation enabled caregivers to progress from hands-on experimentation to active problem-solving, demonstrating the stages outlined in KLT. Several themes emerged including preconceptions about simulation, emotional response, crisis management, safety and risk awareness, and preparation for home care. All caregivers reported an increase in confidence and competence and greater comfort in their ability to care for their child at home. Caregivers also highlighted the significance of debriefing, noting that these reflective sessions were as equally important as the scenarios.

High-fidelity tracheostomy simulation is a valuable learning method for caregivers and should be a critical part of tracheostomy education programs. However, it remains unclear if caregivers' perceived confidence and competence translates to successful emergency responses at home. Future studies are needed to better understand the overall impact of simulation training on caregiver competence and subsequent child outcomes.