Implementation of a Novel, Intensive, Two-Week Simulation Rotation for Pediatric Residents to Teach Crisis Resource...

Background Pediatric residents must be competent in leading resuscitations, but have few clinical opportunities to develop their crisis resource management (CRM) skills. Simulation-based medical education (SBME), including CRM training, can supplement resident education where clinical experience is lacking. Objectives To develop and evaluate the feasibility, acceptability, and effectiveness of an SBME rotation for pediatric residents to improve competency and confidence in CRM skills. Methodology We designed a 10-day rotation with 31 unique simulations for residents interested in developing their CRM skills. A pre- and post-course survey evaluated the acceptability and effectiveness of the rotation. To assess leadership skills, a core component of CRM, we used the Concise Assessment of Leader Management (CALM) tool. Results Over six rotations, 38 residents participated, and 27 (71%) completed both the pre- and post-surveys. All 27 residents would recommend the rotation to other residents. After completing the course, the residents reported improvement in confidence (median (interquartile range, IQR): 2 (2, 3) vs. 4 (3, 4), P-value < 0.0001, n = 27) and capability (median (IQR): 3 (2, 3) vs. 4 (4, 4), P-value < 0.0001, n = 27) when approaching a patient requiring resuscitation. CALM scores improved for the residents in their last simulation compared to their first simulation (median (IQR): 52.50 (49.25, 55.00) vs. 30.50 (20.75, 35.50), P-value < 0.0001, n = 16), indicating an improvement in leadership. Conclusions We developed a novel, intensive, simulation-based rotation for pediatric residents that was feasible, acceptable, and improved residents' capability, confidence, and leadership skills when approaching a patient resuscitation.