Clinical decision-making training using the Script Concordance Test and simulation: A pilot study for pediatric residents

E Baudou; C Guilbeau-Frugier; I Tack; F Muscari; I Claudet; E Mas; A Taillefer; S Breinig; C Bréhin

doi:10.1016/j.arcped.2023.03.007

Clinical decision-making training using the Script Concordance Test and simulation: A pilot study for pediatric residents

Arch Pediatr. 2023 Aug;30(6):355-360. doi: 10.1016/j.arcped.2023.03.007. Epub 2023 May 3.

Authors

E Baudou¹, C Guilbeau-Frugier², I Tack³, F Muscari⁴, I Claudet⁵, E Mas⁶, A Taillefer⁵, S Breinig⁷, C Bréhin⁸

Affiliations

¹ Unité de Neurologie Pédiatrique, Hôpital des Enfants, CHU de Toulouse, Toulouse, France.
² Unité de Médecine Légale, CHU de Toulouse, Toulouse, France.
³ Explorations Fonctionnelles Physiologiques, Hôpital Rangueil, CHU de Toulouse, Toulouse, France.
⁴ Unité de Chirurgie Digestive, CHU de Toulouse, Toulouse, France.
⁵ Unité d'Urgences et Infectiologie Pédiatrique, Hôpital des Enfants, CHU de Toulouse, Toulouse, France.
⁶ Unité de Gastroentérologie, Hépatologie, Nutrition, Diabétologie et Maladies Héréditaires du Métabolisme, Hôpital des Enfants, CHU de Toulouse, F-31300, IRSD, Université de Toulouse, INSERM, INRAE, ENVT, UPS, Toulouse, France.
⁷ Unité de Réanimation Pédiatrique, Hôpital des Enfants, CHU de Toulouse, Toulouse, France.
⁸ Unité d'Urgences et Infectiologie Pédiatrique, Hôpital des Enfants, CHU de Toulouse, Toulouse, France. Electronic address: baudou.e@chu-toulouse.fr.

PMID: 37147153
DOI: 10.1016/j.arcped.2023.03.007

Abstract

Background: Each year, new pediatric residents begin their shifts in the pediatric emergency room. While technical skills are often acquired during workshops, non-technical skills such as communication, professionalism, situational awareness, or decision-making are rarely tested. Simulation enables non-technical skills to be developed in situations frequently encountered in pediatric emergencies. Adopting an innovative approach, we combined two pedagogical methods: the Script Concordance Test (SCT) and simulation to improve clinical reasoning and non-technical skills of first-year pediatric residents in dealing with clinical situations involving febrile seizures. The aim of this work is to report the feasibility of such a combined training.

Methods: The first-year pediatric residents participated in a training session on how to manage a child attending the emergency department with a febrile seizure. At the beginning of the session, the trainees had to complete the SCT (seven clinical situations) and then participated in three simulation scenarios. Student satisfaction was assessed by means of a questionnaire at the end of the session.

Results: In this pilot study, 20 residents participated in the training. The SCT scores for the first-year pediatric residents were lower and more widely distributed than those of the experts with better concordance for diagnostic items compared to investigation or treatment items. All were satisfied with the teaching methods employed. Further sessions on additional topics relating to the management of pediatric emergency cases were requested.

Conclusion: Although limited by the small size of our study, this combination of teaching methods was possible and seemed promising for the development of non-technical skills of pediatric residents. These methods are in line with the changes being made to the third cycle of medical studies in France and can be adapted to other situations and other specialties.

Keywords: Febrile seizures; Non-technical skills; Pediatric emergency; Pediatric residents; Script Concordance Test; Simulation.

MeSH terms

Child
Clinical Competence
Clinical Decision-Making
Educational Measurement / methods
Humans
Internship and Residency*
Pilot Projects