"Sim One, Do One, Teach One": A Simulation-Based Trauma Orientation for Pediatric Residents in the Emergency Department

Abstract

Objectives: The objective of this study was to determine the effectiveness of a simulation-based curriculum in improving confidence in trauma resuscitation skills and increasing attendance during trauma resuscitations for pediatric residents during their emergency medicine rotation.

Methods: A simulation-based orientation curriculum was implemented for the 2017-2018 academic year. Participants completed a qualitative survey before and after each session to assess their comfort level with skills required in a trauma resuscitation. Responses were compared using the Wilcoxon ranked sum test. Nursing documentation was reviewed for the 2016-2017 and 2017-2018 academic years to determine the frequency of resident attendance at trauma resuscitations. Pediatric resident attendance before and after intervention were compared via χ2 analysis.

Results: Survey responses showed a significant increase in confidence in all skills assessed, including primary and secondary survey performance, knowledge of pediatric resident role, knowledge of necessary equipment, ability to determine acuity of patient illness or injury, and ability to differentiate between modes of oxygen delivery (P < 0.01). There was no statistically significant change in the frequency of pediatric resident attendance at trauma bay resuscitations before and after curriculum implementation (21.2% vs 25.7%, P = 0.09).

Conclusions: Through the implementation of a simulation-based trauma orientation for pediatric residents, we were able to improve self-reported confidence in trauma resuscitation skills. This improvement did not result in an increased attendance at trauma resuscitations. Next steps include identifying additional barriers to pediatric resident attendance at trauma bay resuscitations.