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Mastering Pediatric Airway Skills: A Procedural Simulation Using Rapid Cycle Deliberate Practice for Emergency
1Department of Emergency Medicine, Division of Pediatric Emergency Medicine Rutgers New Jersey Medical School Newark New Jersey USA.
AEM Education and Training
|May 13, 2026
Summary
A simulation-based pediatric airway curriculum improved emergency medicine residents' skills and confidence in managing critical pediatric airways. This training addresses significant gaps in pediatric emergency medicine education, enhancing procedural competency.
Area of Science:
- Medical Education
- Emergency Medicine
- Pediatric Critical Care
Background:
- Pediatric emergency medicine (PEM) training in emergency medicine (EM) residency programs shows significant variability in essential areas like preceptor expertise and procedural exposure.
- Limited and inconsistent real-world exposure to critically ill children hinders effective pediatric airway management training for residents.
- Current Accreditation Council for Graduate Medical Education (ACGME) guidelines offer insufficient direction on pediatric-specific content and mandatory procedures, creating training gaps.
Purpose of the Study:
- To enhance pediatric airway knowledge and procedural competency among EM residents through a longitudinal, simulation-based curriculum.
- To improve resident confidence and skills in pediatric airway equipment setup, bag-valve-mask (BVM) ventilation, troubleshooting, and intubation techniques.
- To address identified deficiencies in pediatric airway management skills using a flipped classroom model and rapid cycle deliberate practice (RCDP).
Main Methods:
- Implementation of a 12-month curriculum based on Kern's framework and Sawyer's procedural learning model, incorporating asynchronous learning and eight simulation sessions.
- Participation of 40 residents across four postgraduate years (PGY) in annual RCDP sessions, with faculty trained in pediatric airway management.
- Objective performance assessment using a novel checklist to evaluate procedural skills.
Main Results:
- Significant improvements observed in pediatric airway equipment setup and intubation steps (p < 0.05) among 31 completing residents.
- Reduction in first-pass intubation time from 9 minutes 12 seconds to 7 minutes 9 seconds (p < 0.05).
- Increased self-reported confidence in pediatric airway management and improved knowledge scores (7.8 to 9.7, p < 0.05) across all PGY levels.
Conclusions:
- A structured, simulation-based pediatric airway curriculum utilizing RCDP effectively enhances EM residents' procedural performance and confidence.
- This educational model provides a scalable solution for addressing critical skill gaps in pediatric emergency medicine training.
- Future research should focus on integrating advanced airway techniques and assessing longitudinal skill retention.
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