Simulation-based medical training for paediatric residents in Italy: a nationwide survey

Marco Binotti,Alice Monzani,Stefano Rizzollo,Pier Luigi Ingrassia,Marco De Luca,Giulia Genoni,Luca Carenzo

doi:10.1186/s12909-019-1581-3

Abstract

BackgroundA prompt start to an appropriate neonatal and paediatric resuscitation is critical to reduce mortality and morbidity. However, residents are rarely exposed to real emergency situations. Simulation-based medical training (SBMT) offers the opportunity to improve medical and non-technical skills in a controlled setting. This survey describes the availability and current use of SBMT by paediatric residents in Italy with the purpose of understanding residents’ expectations regarding neonatal and paediatric emergency training, and identifying gaps and potential areas for future implementation.MethodsA survey was developed and distributed to Italian residents. SBMT was defined as any kind of training with a mannequin in a contextualised clinically realistic scenario.ResultsThe response rate was 14.4%, covering the 71% of Italian paediatric residency programmes. Among them, 88% stated that Out of the 274 residents, 88% stated that they received less than 5 h of SBMT during the past training year, with 66% not participating in any kind of simulation activity. In 62% of the programmes no simulation training facility was available to residents. Among those who received SBMT, 46% used it for procedures and skills, 30% for clinical scenarios, but only 24% of them reported a regular use for debriefing. Of the overall respondents, 93% were interested in receiving SBMT to improve decision-making abilities in complex medical situations, to improve technical/procedural skills, and to improve overall competency in neonatal and paediatric emergencies, including non-technical skills. The main barriers to the implementation of SBMT programmes in Italian paediatric residencies were: the lack of experts (57%), the lack of support from the school director (56%), the lack of organisation in planning simulation centre courses (42%) and the lack of teaching materials (42%).ConclusionsThis survey shows the scarce use of SBMT during paediatric training programmes in Italy and points out the main limitations to its diffusion. This is a call to action to develop organised SBMT during paediatric residency programs, to train qualified personnel, and to improve the quality of education and care in this field.

Highlights

A prompt start to an appropriate neonatal and paediatric resuscitation is critical to reduce mortality and morbidity
The aim of this study is to describe the current use of simulation in paediatric residency programmes in Italy, in order to understand the expectations of residents with regard to neonatal and paediatric emergency training, as well as to identify gaps and potential areas for future implementation
Simulation exposure In the 2015–2016 academic year, 88% of respondents spent less than 5 h in Simulation-based medical training (SBMT), with approximately 66% not participating in any kind of simulation activity (Fig. 1)

Summary

Introduction

A prompt start to an appropriate neonatal and paediatric resuscitation is critical to reduce mortality and morbidity. Simulation-based medical training (SBMT) offers the opportunity to improve medical and non-technical skills in a controlled setting. This survey describes the availability and current use of SBMT by paediatric residents in Italy with the purpose of understanding residents’ expectations regarding neonatal and paediatric emergency training, and identifying gaps and potential areas for future implementation. Simulation-based medical training (SBMT) has been defined as the artificial representation of a complex real-world process with sufficient fidelity with the aim to facilitate learning through immersion, reflection, feedback, and practice minus the risks inherent in a similar real-life experience [1] It may be based on the use of mannequins, partial task trainers, virtual reality, or trained actors, as an alternative to real patients, allowing for the creation of realistic but well-controlled clinical settings that simulate real-life patient care. Recent surveys showed that SBMT is used by more than 90% of U.S, Canadian and English-language-based emergency medicine residency programmes, even though a considerable variability in the accreditation and certification, and frequency and timing of SBMT has been highlighted [10, 11]

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