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Improving the Pediatric Emergency Department Learning Experience: A Simulation-Based Orientation for Pediatric PGY 1 Residents
INTRODUCTION: Rotations in the pediatric emergency department (PED) may expose residents to very few critically ill patients. In our previous work, interns at our institution showed low self-confidence in decision-making and preparedness to stabilize acutely ill patients. In order to improve this, w...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Association of American Medical Colleges
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7331952/ https://www.ncbi.nlm.nih.gov/pubmed/32656335 http://dx.doi.org/10.15766/mep_2374-8265.10919 |
Sumario: | INTRODUCTION: Rotations in the pediatric emergency department (PED) may expose residents to very few critically ill patients. In our previous work, interns at our institution showed low self-confidence in decision-making and preparedness to stabilize acutely ill patients. In order to improve this, we designed a new, peer-led, simulation-based orientation to the PED rotation for interns focusing on workflow and decision-making. The cases presented learners with practical and generalizable challenges, such as ordering initial labs and medications and defining the ultimate disposition for the patient. METHODS: This orientation curriculum was designed for first-year residents using high-fidelity simulation mannequins. In the first of two cases, learners managed a 10-year-old boy presenting with status asthmaticus who required continuous albuterol and parenteral magnesium to achieve stability for admission. In the second case, a 4-year-old girl with short gut syndrome and an indwelling central line presented with fever, was found to be septic, but responded well to fluid resuscitation and antibiotic therapy. RESULTS: Over 2 years of implementation, 39 residents participated. Pre- and postintervention Likert-based survey evaluations showed significant increases in confidence in decision-making and preparedness to stabilize acutely ill children that were not seen in a control group during the pilot year. A subsequent class-wide implementation showed similar significant improvements, as well as increased comfort initiating treatment prior to staffing. DISCUSSION: Using simulation mannequins in a case-based orientation can improve PGY 1 residents’ self-confidence and sense of preparedness during their first rotation in the PED. |
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