Simulation-Based Peer Feedback Module for Pediatric Rapid Response Team Handoffs

Deterioration of pediatric patients outside the PICU increases morbidity and mortality. Effective communication during rapid response team (RRT) events is essential. Although frameworks like SBAR (Situation, Background, Assessment, Recommendation) and ABC (Airway, Breathing, Circulation) exist, standardized RRT training for residents remains limited. This educational innovation integrates simulation, peer feedback, and deliberate practice to enhance resident communication, confidence, and handoff skills.

Forty-four (52%) of 84 eligible pediatrics and internal medicine/pediatrics residents participated in a simulation-based module in 2022 prior to their pediatric inpatient rotation; 35 completed full training and surveys. The module included a baseline simulation, targeted instruction, practice scenarios with peer feedback, and a final simulation. Objectives focused on ABC-SBAR use, data synthesis, and increased confidence in leading RRTs. Pre- and postmodule surveys assessed knowledge and confidence. Faculty, who were masked to the participant's identity, measured ABC-SBAR handoff scores using audio recordings; peer evaluators also scored in-person simulations.

ABC-SBAR scores improved significantly (mean 5.1/12 to 9.3/12 pre- to postmodule, p < .001), with 32% of participants after training versus 5% before training reporting high confidence in leading a pediatric RRT (p < .001). Residents with no prior RRT experience showed the most significant gains. More than 50% of participants believed the training would improve real-world RRT performance.

This simulation-based module improved structured communication and leadership skills for pediatric RRT events. The approach is scalable and adaptable across training sites to enhance resident preparedness and patient safety.