First 3 Minutes: A Rapid Cycle Deliberate Practice Pediatric Resuscitation Simulation for Multidisciplinary Staff

Medical staff on acute care wards respond to in-hospital emergencies, yet they are often poorly prepared due to the infrequency of pediatric cardiopulmonary events. We developed this rapid cycle deliberate practice simulation to improve the skills and knowledge required to initiate high-quality CPR and prepare for the arrival of the code blue response team.

This 30-minute simulation was performed in situ within hospital rooms and required low-fidelity equipment. Participants resuscitated an unresponsive, pulseless infant. The simulation was conducted three times, with each participant cycling through each role. Critical actions included checking for responsiveness and calling for help, starting compressions, ventilating the patient, and placing defibrillation pads while maintaining high-quality CPR.

Participants' (attending physicians', pediatric trainees', advanced practice providers', registered nurses') self-reported confidence, as rated based on a 5-point Likert scale (1 = strongly disagree, 5 = strongly agree), significantly improved in providing high-quality CPR (n = 151; Z = 9.4; p < .01) and managing airway, breathing, and circulation in the first 3 minutes of a code situation (n = 154; Z = 9.6; p < .01). Knowledge scores (four multiple-choice questions) assessing high-quality CPR principles improved from a mean 68% to 85% (n = 151; p < .01). Respondents indicated they found the training session to be helpful, with a mean score of 4.8 on a 5-point Likert scale (1 = not at all helpful, 5 = extremely helpful).

This multidisciplinary simulation was well received and improved participants' confidence in responding to pediatric cardiopulmonary emergencies and knowledge of high-quality CPR principles.