Pediatr Emerg Med J.  2025 Jan;12(1):10-19. 10.22470/pemj.2024.01109.

A novel simulation-based Pediatric Respiratory Distress Educational Curriculum (PReDEC) for emergency medicine residents

• Croft A
• Barach P
• Bona A
• Novotny N
• Baluyot M
• Falvo L
• Cooper D
• Moore M
• Lacy AJ
• Abu-Sultaneh S
• Swinger N
• Espinoza J
• Sarmiento E
• Abulebda K
• Ahmed R

• KMID: 2563127
• DOI: http://doi.org/10.22470/pemj.2024.01109

Abstract

Purpose
It is important for emergency physicians to be able to evaluate and manage pediatric respiratory distress, which is rare in general emergency departments. Despite this importance, the emergency departments show inconsistency in pediatric readiness, while emergency medicine (EM) residents express discomfort in caring for critically ill children due to limited exposure during their residency training. The purpose of this study was to meet this educational need by developing and implementing a curriculum to prepare EM residents to provide safe care for pediatric respiratory distress.
Methods
We prospectively assessed 20 senior EM residents after undergoing a 3-hour simulation-based curriculum at Indiana University School of Medicine. The curriculum was developed using the Kern’s methodology by content experts. Pre- and post-curriculum confidence, knowledge, competency, and situational awareness were assessed using the 5-point Likert scale, multiple-choice questions, checklists of a pediatric acute respiratory distress scenario, and a novel modified video version of the situational awareness global assessment technique, respectively.
Results
From the pre- to post-intervention phases, the confidence improved from 3.2 ± 0.4 to 3.9 ± 0.2 on the Likert scale (P < 0.001). The knowledge improved from 50.3% ± 12.9% to 75.3% ± 10.6% on the multiple-choice questions (P < 0.001). The competency improved from 46.8% ± 16.0% to 73.6% ± 10.6% (P < 0.001) with significant improvements in 7 of the 14 checklist items. The situational awareness raised both data perception (P < 0.001) and comprehension (P = 0.004) with no significant improvements in data extrapolation (P = 0.120).
Conclusion
Preliminary findings suggest that a 3-hour simulation-based curriculum for EM residents, including implementation of a novel situational awareness assessment tool, can improve learner’s confidence, knowledge, competency, and situational awareness of pediatric respiratory distress.

Keyword

Airway Management; Awareness; Ergonomics; Pediatric Emergency Medicine; Respiratory Insufficiency; Simulation Training; Surveys and Questionnaires

Figure

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  Fig. 1. The initial assessment of intubated hypoxia in pediatric patients. Modified from Pacheco et al. (20) with permission of Elsevier. ABCs: airway, breathing, and circulation, ETT: endotracheal tube, POCUS: point-of-care ultrasound.

Reference

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