Developing a Virtual Paediatric CRRT Simulator: Global Reach and Learning Insights
Amrit Kirpalani1,2, Cory Alec Manzo Anderson3,4, Hannah Yassine4
1Department of Paediatrics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada, amrit.kirpalani@lhsc.on.ca.
Blood Purification
|March 2, 2026
Summary
A new screen-based simulator for pediatric continuous renal replacement therapy (CRRT) training is accessible globally. This low-cost tool addresses competency gaps in pediatric intensive care units by offering interactive cases and revealing practice variations.
Area of Science:
- Pediatric Critical Care Medicine
- Medical Simulation
- Nephrology Education
Background:
- Continuous renal replacement therapy (CRRT) is vital in pediatric critical care but provider competency is difficult to maintain due to low case volumes and limited training resources.
- Traditional high-fidelity simulation is effective but resource-intensive, hindering scalability and global accessibility.
- Screen-based simulation offers a cost-effective alternative to bridge educational gaps in CRRT.
Purpose of the Study:
- To develop and evaluate a free, browser-based screen simulation platform for pediatric CRRT decision-making.
- To assess the platform's reach, user engagement, and ability to highlight clinical practice variations.
- To determine the scalability and utility of screen-based simulation for CRRT training.
Main Methods:
- Development of the Paediatric CRRT Simulator, a free, web-based platform with 21 interactive cases using decision trees and adaptive learning.
- Analysis of aggregated, anonymized Google Firebase Analytics data from users between July 9 and October 6, 2025.
- Metrics included unique users, session frequency, geographic distribution, and case-level clinical decisions, with countries classified by World Bank income categories.
Main Results:
- The simulator attracted 2,578 unique users from 92 countries, including 25 low- and middle-income countries, within a 90-day period.
- Significant practice variations were observed in clinical decisions, such as anticoagulation choices and fluid priming strategies, across different cases.
- Forty-four percent of users returned for additional sessions, indicating engagement and potential for repeated learning.
Conclusions:
- Screen-based CRRT simulation is a scalable and accessible method for enhancing pediatric critical care provider training.
- The platform effectively identifies variations in clinical practice, providing valuable data for curriculum development and standardization.
- This approach offers a low-cost solution to improve CRRT competency globally, particularly in resource-limited settings.
