From Consensus to Practice: Implementation and Impact of the Emergency Medicine Simulation Curriculum for Pediatrics...

Background Exposure to critically ill children during emergency medicine (EM) residency is limited and variable. General EDs care for over 85% of the 36 million annual pediatric ED visits in the U.S., highlighting a training gap. To address this, the Emergency Medicine Resident Simulation Curriculum for Pediatrics (EM ReSCu Peds) was developed by more than 50 pediatric simulation experts as a free, open-access curriculum of 16 peer‑reviewed cases. Representatives from 10 national EM, pediatric EM (PEM), and simulation organizations, along with contributors from 44 institutions, created and iteratively refined each case. Case toolkits include learning objectives, critical actions, debriefing guides, and instructor resources. Using a regional‑champion strategy to support dissemination, this hybrid implementation‑effectiveness study evaluated dissemination (web analytics), implementation, and educational effectiveness (user satisfaction and feedback). Methodology Dissemination used a multimodal approach with an open-access website and downloadable PDF book. Regional champions promoted local implementation and collected learner and facilitator data. From July 2021 to January 2025, dissemination was assessed via website visits, PDF downloads, and case access patterns. Implementation and effectiveness were evaluated using anonymous facilitator and learner surveys administered via QR codes after sessions. Surveys assessed demographics, satisfaction using Net Promoter Score (NPS), perceived educational effectiveness on Likert scales, and barriers through open-ended responses. Results The curriculum PDF was downloaded 2,278 times, and the website received 11,296 views from 594 cities across 64 countries. Most‑viewed cases included supraventricular tachycardia (1,918 views), diabetic ketoacidosis (1,895), and anaphylaxis (1,836). Least‑viewed cases included pulseless electrical activity/ventricular fibrillation (681), neonatal delivery (685), and penetrating trauma (774). Surveys included 84 facilitators and 514 learners from nine U.S. institutions across four regions. Facilitators were 51.3% faculty, 25% fellows, 17.1% residents; 59.5% had PEM fellowship training and 33.8% EM training. All sessions involved EM residents; some included pediatric residents (16.7%), nurses (15.5%), and other staff (42.9%). Facilitator NPS was 72 (81.6% promoters); learner NPS was 74 (78% promoters). Case‑specific NPS ranged from 70-90. Facilitators strongly agreed that cases effectively taught basic skills (92%), advanced skills (87%), and were realistic (76%). Learners reported similarly strong agreement: 96% for basic skills, 91% for advanced skills, 84% for realism. Qualitative themes highlighted needs for trauma references (23.2%), multimedia adjuncts (18.3%), and concise facilitator guides (26.8%). In response, two‑page facilitator flowsheets, updated trauma references, optimized imaging formats, and procedural video links were added. Conclusions EM ReSCu Peds showed successful global dissemination and high satisfaction, supported by a targeted regional‑champion implementation model. Both groups provided NPS scores above 70, reflecting a "world‑class" educational product. Over 90% of users endorsed effectiveness in teaching pediatric resuscitation skills. Given modest survey response relative to website traffic, generalizability may be limited. Future work will focus on strengthening data capture, expanding multimedia resources, and evaluating clinical impact.