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Development and Validation of a Simulation-Based Pediatric Anesthesia Training Program in Japan: The J-MEPA

Sachi Ishida^1,2,3, Tomoe Sakurai^1,4, Satoshi Ohashi¹

¹Department of Anesthesiology, Saitama Children's Medical Center, Saitama, Japan.

Paediatric Anaesthesia

|April 22, 2026

Summary

A new simulation program, Japanese version of Managing Emergencies in Pediatric Anesthesia (J-MEPA), was developed to address pediatric anesthesia training gaps in Japan. The program showed acceptable reliability and validity, with participants reporting increased confidence and motivation.

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Area of Science:

Anesthesiology
Medical Education
Simulation Training

Background:

Pediatric anesthesia poses higher risks than adult anesthesia.
Limited clinical exposure to pediatric cases in Japan due to demographic shifts.
Lack of a validated pediatric anesthesia simulation program in Japan.

Purpose of the Study:

To develop and implement a culturally adapted simulation-based training program for pediatric anesthesia in Japan.
The program is named the Japanese version of Managing Emergencies in Pediatric Anesthesia (J-MEPA).

Main Methods:

Phase 1: Translation, cultural adaptation, and feasibility testing of the English MEPA course.
Phase 2: Implementation of J-MEPA, evaluating inter-rater reliability, criterion-related validity, and educational effectiveness.
Performance assessment using video recordings, a revised checklist, and behaviorally anchored rating scale (BARS), with reliability assessed by intraclass correlation coefficients (ICC).

Main Results:

Forty-four participants completed 209 simulations.
Acceptable inter-rater reliability for both the revised checklist (ICCs 0.54–0.86) and BARS (ICCs 0.50–0.79).
Positive correlation between BARS scores and pediatric experience, indicating preliminary validity; participants reported high satisfaction, engagement, and increased confidence.

Conclusions:

The Japanese version of MEPA (J-MEPA) was successfully developed and preliminarily evaluated.
Demonstrated acceptable reliability, initial criterion-related validity, and positive educational outcomes.
J-MEPA provides a feasible, culturally appropriate solution for pediatric anesthesia training gaps in Japan, potentially serving as a model for other contexts.