Increasing pediatric resident simulated resuscitation performance: a standardized simulation-based curriculum.

Abstract

Studies demonstrating the impact of resuscitation simulation curricula on performance are limited. Our objective was to create and evaluate a simulation-based resuscitation curriculum's impact on pediatric residents' performance in a simulated resuscitation. We developed a standardized simulation-based pediatric resident resuscitation curriculum consisting of nine modules, incorporating four domains (basic skills, airway/breathing, circulation and team management) and specific topics (e.g., anaphylaxis). Each module was presented four times over the academic year. Evaluation of the curriculum consisted of pre- and post-intervention video-recorded performances of a simulated pediatric resuscitation by 10 resident resuscitation teams, scored using the Simulation Team Assessment Tool (STAT). The effectiveness of the standardized curriculum on medical (basics, airway/breathing, circulation) and team management, and on knowledge test scores was evaluated by comparing pre- and post-intervention STAT scores using unpaired two-sided T-test. The impact of group curriculum participation on team performance (STAT scores) was analyzed using linear regression. Overall team performance STAT scores increased post-intervention (mean pre-test 0.61, post-test 0.74, p<0.001), as did management of the basics of resuscitation, airway/breathing and teamwork (mean basics: pre 0.46, post 0.62, p=0.001; mean airway/breathing: pre 0.63, post 0.76, p=0.01; mean teamwork: pre 0.61, post 0.79, p=0.003). Regression analysis provided evidence for a training "dose-response" among the post-intervention teams, with teams exposed to more training achieving higher performance scores (p=0.004). We created a standardized simulation-based pediatric resuscitation curriculum that increased pediatric residents' scores on medical management and teamwork skills in a dose dependent relationship.