High-Fidelity Medical Simulation as a Technique to Improve Pediatric Residents' Emergency Airway Management and Teamwork

Abstract

High-fidelity medical simulation is a technique used for training residents. Simulation is used to teach procedural skills and teamwork. There are limited data on the efficacy of this educational technique. We hypothesize that simulation is effective for teaching pediatric residents airway skills and teamwork. We performed a randomized crossover trial with 16 postgraduate year 2 residents at the Rhode Island Hospital Medical Simulation Center. The residents were given a standard introduction to the simulation center then managed 2 scenarios, during which baseline airway and teamwork skills were assessed. The participants were divided into 2 groups. Group 1 returned for a simulation-enhanced session on pediatric airway management and teamwork, whereas group 2 received no supplemental education. Two months later, groups 1 and 2 were reassessed. Subsequently, group 2 returned for the same intervention as group 1. Both groups returned for a final assessment. Data were collected using the Rhode Island Hospital Medical Simulation Center global competency score, critical action checklists, harmful actions lists, and the Behaviorally Anchored Rating Scale. The mean global competency score improved and showed a statistically significant relationship between the intervention and the performance. Critical actions showed a statistically insignificant trend of improvement. There was a striking reduction in the number of harmful actions. The Behaviorally Anchored Rating Scale improved at each session though statistically unrelated to the intervention. This study supports simulation-enhanced educational strategies for improving performance and teamwork skills. This technique is effective in teaching pediatric residents airway skills and teamwork fundamentals required to efficiently manage an acute airway situation.