Cumulative Evaluation Data: Simulation Based Learning Courses for Pediatric R1 Residents

Abstract

Objectives: To utilize cumulative evaluation data of the Intensive pediatric simulation-based learning course on knowledge and practical skills for pediatric R1 residents at Saudi Commission for Health Speciality (SCFHS) in order to measure its efficacy and areas for improvement. Methods: This evaluation design is a retrospective cohort study that compares pre- post- and retention test 6 months later (knowledge and skills) of an intensive pediatric R1 simulation course. The five-day bundle courses has been conducted once per month at CRESENT and is comprised of airway management with crew resource management, central line insertion under ultrasound guidance, thoracocentesis and chest tube insertion, chest X-ray interpretation and lung ultrasound, lumbar puncture and bone marrow aspiration and biopsy and cardiac simulation course. Our evaluation data includes all pediatric R1 residents who attended the course between September 2017 and May 2018. Results: A total number of 43 trainees, 23 residents (43.5%) are males and 20 (46.5%) are females.18 (41.9%) are KfMC residents and 25 (58.1%) non-KFMC residents (Table 1). Overall, there is statistically significant improvement between the pretest and post-test knowledge and practical skills scores for all the courses. Airway management simulation course, central line catheter insertion under ultrasound guidance course and lumbar puncture course a comparative analysis for knowledge and practical skills assessment of pre-test and post-test mean scores showed significant statistical improvement with P-value <0.001. Similarly, a comparative analysis for knowledge assessment of pre-test and post-test mean scores for all the five courses including pediatric cardiac simulation course and pediatric chest X-ray interpretation course showed significant statistical improvement with P-value <0.001.Retention test were limited to 4 candidates did retention practical skills test and showed 100% improvement in their scores while 9 candidates did retention knowledge test for airway management course, central line insertion under ultrasound guidance course and lumbar puncture course which showed 50% less than post test but more than pretest score, 30% had equivocal as post test and 20% more than post test score. Majority enjoyed training in simulation environment Discussion: This study shows the importance and effectiveness of the pediatric simulation courses for pediatric R1 residents under SCFHS training programs. The striking results are the improvement in all assessed categories of knowledge and practical skills for all the courses, although the retention candidates were few but striking result of significant retaining the practicle skills and even retaining the knowledge as non scored similar or below pre test score. Which makes a strong argument to mandate such courses to all pediatric residents. Further research is needed to study skills’ retention more widelyand more importantly its impact on patients’ care. Although resource-intensive, the use of cumulative evaluation data helped to focus quality improvement in our courses.