A national needs assessment to inform simulation-based education for pediatric hospital medicine

Pediatric Hospital Medicine (PHM) has historically underutilized simulation-based medical education (SBME), a proven methodology for improving education and patient care. This study sought to identify and prioritize simulation-appropriate topics to inform a comprehensive PHM SBME curriculum for practicing hospitalists.

In Phase 1, local and national PHM and simulation experts generated and refined a list of potential topics, categorized into cognitive, psychomotor, and affective domains. In Phase 2, a nationally representative sample of pediatric hospitalists from the Pediatric Research in Inpatient Settings (PRIS) Network ranked their top six topics within each domain. Mean priority scores were calculated for each topic, and high-priority topics (HPTs) were identified utilizing natural breaks analysis, then expanded to balance topics across domains.

Topic generation and expert panel refinement yielded 19 cognitive, 26 psychomotor, and 12 affective topics. These were prioritized by 52 pediatric hospitalists (of 99 [53%] surveyed). Fifteen HPTs were identified: five cognitive (respiratory distress/failure, shock, behavioral escalation, medical technology failure, sepsis), five psychomotor (lumbar puncture, bag-valve-mask ventilation, tracheostomy management, enteral tube management, chest compressions), and five affective (patient/family communication, de-escalation, interprofessional collaboration, handoffs, diagnostic error avoidance strategies) topics. Subgroup analysis revealed small variations across rater demographic characteristics.

Fifteen top-rated PHM SBME topics are suitable for inclusion in a comprehensive curriculum that can be adapted at diverse institutions nationwide. Implementation may augment existing continuing medical education in PHM to help standardize care for hospitalized children.