36. DOES EMOTIONAL FIDELITY MATTER? PEDIATRIC RESIDENTS’ PERSPECTIVES DURING EXPECTED VS UNEXPECTED SIMULATION SESSIONS

Abstract

Introduction Simulation-based education has become pervasive in residency. Fidelity is important for relevance and transference of skills to real patient encounters and can be divided into three parts: physical, conceptual, and emotional 1 , 2 . There have been few studies to date evaluating the impact of emotional fidelity, or how close to “real” the simulation feels. Only 26% of Tufts pediatric residents felt they were “comfortable” in their ability to lead a rapid response event, which may be impacted by the unexpected nature of rapid responses. Objective: Evaluate whether being called to a simulation of a decompensating patient without advanced warning affects pediatric residents’ perception of the emotional (EF) and overall fidelity (OF) of the simulation. Methods Pediatric residents participated in a simulation involving a child with respiratory distress. Residents were randomized to one of two groups: Advanced Warning (AW) or No Advanced Warning (NAW). The AW group (control) was notified via text message several hours prior to receiving a page to report to the simulation. The NAW group (intervention) was not notified prior to receiving the page to report to the simulation. All residents completed surveys about their perceptions of fidelity. Results Nineteen residents have provided data to date. Mean scores on a 5-point Likert item rating EF of the simulation (1 = extremely unrealistic, 5 = extremely realistic) were 2.9 (AW) and 3.8 (NAW) (p-value 0.04). Mean scores for OF were 2.6 (AW) and 3.3 (NAW) (p-value 0.28). Discussion Reported experience of EF but not OF was higher for residents given NAW than those given AW. Data collection is ongoing. Limitations of this study include low physical fidelity and small sample size.