Enhancing Knowledge and Skills in Pediatric Neurologic Emergencies: A Simulation-Based Medical Education Program for...

India has one of the largest pediatric populations globally, with one in five children affected by a neurological condition. However, access to specialized pediatric neurology care is limited due to a shortage of trained pediatric neurologists. Most pediatric neurology cases are managed by emergency medicine (EM) physicians, adult neurologists, or pediatricians. Strengthening EM physicians' ability to recognize and manage these conditions is critical. Simulation-based medical education (SBME) offers an effective avenue to enhance knowledge, procedural skills, and self-efficacy.

The Ronald Reagan Institute of Emergency Medicine at George Washington University has partner programs across India to deliver postgraduate EM training programs. In October 2024, a 2-week, in-person pediatric neurology SBME training was conducted across eight partner sites. Faculty included three visiting specialists in pediatric EM and EM, one pediatric neurology resident, and local EM faculty. Training included a didactic session on pediatric neurological emergencies, a procedural workshop, and simulation cases in pediatric neurology emergencies. The structured procedural workshops used pre-existing checklists to achieve mastery learning in pediatric skills: Intravenous access, intraosseous access, bag-valve-mask ventilation, intubation, and lumbar puncture. Trainees completed three pediatric neurology simulation clinical cases, including procedural skills. Pre- and posttests, including a 3-month follow-up knowledge test and survey, were used to evaluate the effectiveness of the educational intervention.

A total of 106 EM trainees from eight sites across India participated in the study with matched pre- and postintervention data. Statistically significant improvements were observed across all domains: Medical knowledge, self-efficacy in procedural skills, and managing pediatric neurologic emergencies.

The findings of this study suggest that SBME can enhance EM trainees' self-efficacy, knowledge, and procedural skills in managing pediatric neurological emergencies. The training model is scalable, adaptable, and effective in resource-variable environments.