A Statewide Collaboration to Deliver and Evaluate a Pediatric Critical Care Simulation Curriculum for Emergency Medical Services
ObjectiveCare of the critically ill child is a rare but stressful event for emergency medical services (EMS) providers. Simulation training can improve resuscitation care and prehospital outcomes but limited access to experts, simulation equipment, and cost have limited adoption by EMS systems. Our...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2022-06-01
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| Series: | Frontiers in Pediatrics |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2022.903950/full |
| _version_ | 1828334620348776448 |
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| author | Caitlin Farrell Kate Dorney Bonnie Mathews Tehnaz Boyle Anthony Kitchen Jeff Doyle Michael C. Monuteaux Joyce Li Barbara Walsh Joshua Nagler Sarita Chung |
| author_facet | Caitlin Farrell Kate Dorney Bonnie Mathews Tehnaz Boyle Anthony Kitchen Jeff Doyle Michael C. Monuteaux Joyce Li Barbara Walsh Joshua Nagler Sarita Chung |
| author_sort | Caitlin Farrell |
| collection | DOAJ |
| description | ObjectiveCare of the critically ill child is a rare but stressful event for emergency medical services (EMS) providers. Simulation training can improve resuscitation care and prehospital outcomes but limited access to experts, simulation equipment, and cost have limited adoption by EMS systems. Our objective was to form a statewide collaboration to develop, deliver, and evaluate a pediatric critical care simulation curriculum for EMS providers.MethodsWe describe a statewide collaboration between five academic centers to develop a simulation curriculum and deliver it to EMS providers. Cases were developed by the collaborating PEM faculty, reviewed by EMS regional directors, and based on previously published EMS curricula, a statewide needs assessment, and updated state EMS protocols. The simulation curriculum was comprised of 3 scenarios requiring recognition and acute management of critically ill infants and children. The curriculum was implemented through 5 separate education sessions, led by a faculty lead at each site, over a 6 month time period. We evaluated curriculum effectiveness with a prospective, interventional, single-arm educational study using pre-post assessment design to assess the impact on EMS provider knowledge and confidence. To assess the intervention effect on knowledge scores while accounting for nested data, we estimated a mixed effects generalized regression model with random effects for region and participant. We assessed for knowledge retention and self-reported practice change at 6 months post-curriculum. Qualitative analysis of participants' written responses immediately following the curriculum and at 6 month follow-up was performed using the framework method.ResultsOverall, 78 emergency medical technicians (EMTs) and 109 paramedics participated in the curriculum over five separate sessions. Most participants were male (69%) and paramedics (58%). One third had over 15 years of clinical experience. In the regression analysis, mean pediatric knowledge scores increased by 9.8% (95% CI: 7.2%, 12.4%). Most (93% [95% CI: 87.2%, 96.5%]) participants reported improved confidence caring for pediatric patients. Though follow-up responses were limited, participants who completed follow up surveys reported they had used skills acquired during the curriculum in clinical practice.ConclusionThrough statewide collaboration, we delivered a pediatric critical care simulation curriculum for EMS providers that impacted participant knowledge and confidence caring for pediatric patients. Follow-up data suggest that knowledge and skills obtained as part of the curriculum was translated into practice. This strategy could be used in future efforts to integrate simulation into EMS practice. |
| first_indexed | 2024-04-13T21:35:34Z |
| format | Article |
| id | doaj.art-b04a6157d68944fc8a8b894499a208aa |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-04-13T21:35:34Z |
| publishDate | 2022-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-b04a6157d68944fc8a8b894499a208aa2022-12-22T02:29:00ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602022-06-011010.3389/fped.2022.903950903950A Statewide Collaboration to Deliver and Evaluate a Pediatric Critical Care Simulation Curriculum for Emergency Medical ServicesCaitlin Farrell0Kate Dorney1Bonnie Mathews2Tehnaz Boyle3Anthony Kitchen4Jeff Doyle5Michael C. Monuteaux6Joyce Li7Barbara Walsh8Joshua Nagler9Sarita Chung10Division of Emergency Medicine, Department of Pediatrics, Harvard Medical School, Boston, MA, United StatesDivision of Emergency Medicine, Department of Pediatrics, Harvard Medical School, Boston, MA, United StatesDivision of Emergency Medicine, Department of Pediatrics, UMass Medical School, Worcester, MA, United StatesDivision of Emergency Medicine, Department of Pediatrics, Boston University School of Medicine, Boston, MA, United StatesDepartment of Emergency Medicine, Baystate Medical Center, Springfield, MA, United StatesDepartment of Public Health, Emergency Medical Services for Children, Boston, MA, United StatesDivision of Emergency Medicine, Department of Pediatrics, Harvard Medical School, Boston, MA, United StatesDivision of Emergency Medicine, Department of Pediatrics, Harvard Medical School, Boston, MA, United StatesDivision of Emergency Medicine, Department of Pediatrics, Boston University School of Medicine, Boston, MA, United StatesDivision of Emergency Medicine, Department of Pediatrics, Harvard Medical School, Boston, MA, United StatesDivision of Emergency Medicine, Department of Pediatrics, Harvard Medical School, Boston, MA, United StatesObjectiveCare of the critically ill child is a rare but stressful event for emergency medical services (EMS) providers. Simulation training can improve resuscitation care and prehospital outcomes but limited access to experts, simulation equipment, and cost have limited adoption by EMS systems. Our objective was to form a statewide collaboration to develop, deliver, and evaluate a pediatric critical care simulation curriculum for EMS providers.MethodsWe describe a statewide collaboration between five academic centers to develop a simulation curriculum and deliver it to EMS providers. Cases were developed by the collaborating PEM faculty, reviewed by EMS regional directors, and based on previously published EMS curricula, a statewide needs assessment, and updated state EMS protocols. The simulation curriculum was comprised of 3 scenarios requiring recognition and acute management of critically ill infants and children. The curriculum was implemented through 5 separate education sessions, led by a faculty lead at each site, over a 6 month time period. We evaluated curriculum effectiveness with a prospective, interventional, single-arm educational study using pre-post assessment design to assess the impact on EMS provider knowledge and confidence. To assess the intervention effect on knowledge scores while accounting for nested data, we estimated a mixed effects generalized regression model with random effects for region and participant. We assessed for knowledge retention and self-reported practice change at 6 months post-curriculum. Qualitative analysis of participants' written responses immediately following the curriculum and at 6 month follow-up was performed using the framework method.ResultsOverall, 78 emergency medical technicians (EMTs) and 109 paramedics participated in the curriculum over five separate sessions. Most participants were male (69%) and paramedics (58%). One third had over 15 years of clinical experience. In the regression analysis, mean pediatric knowledge scores increased by 9.8% (95% CI: 7.2%, 12.4%). Most (93% [95% CI: 87.2%, 96.5%]) participants reported improved confidence caring for pediatric patients. Though follow-up responses were limited, participants who completed follow up surveys reported they had used skills acquired during the curriculum in clinical practice.ConclusionThrough statewide collaboration, we delivered a pediatric critical care simulation curriculum for EMS providers that impacted participant knowledge and confidence caring for pediatric patients. Follow-up data suggest that knowledge and skills obtained as part of the curriculum was translated into practice. This strategy could be used in future efforts to integrate simulation into EMS practice.https://www.frontiersin.org/articles/10.3389/fped.2022.903950/fullsimulationpediatric critical careprehospital resuscitationemergency medical servicesEmergency Medical Services for Children |
| spellingShingle | Caitlin Farrell Kate Dorney Bonnie Mathews Tehnaz Boyle Anthony Kitchen Jeff Doyle Michael C. Monuteaux Joyce Li Barbara Walsh Joshua Nagler Sarita Chung A Statewide Collaboration to Deliver and Evaluate a Pediatric Critical Care Simulation Curriculum for Emergency Medical Services Frontiers in Pediatrics simulation pediatric critical care prehospital resuscitation emergency medical services Emergency Medical Services for Children |
| title | A Statewide Collaboration to Deliver and Evaluate a Pediatric Critical Care Simulation Curriculum for Emergency Medical Services |
| title_full | A Statewide Collaboration to Deliver and Evaluate a Pediatric Critical Care Simulation Curriculum for Emergency Medical Services |
| title_fullStr | A Statewide Collaboration to Deliver and Evaluate a Pediatric Critical Care Simulation Curriculum for Emergency Medical Services |
| title_full_unstemmed | A Statewide Collaboration to Deliver and Evaluate a Pediatric Critical Care Simulation Curriculum for Emergency Medical Services |
| title_short | A Statewide Collaboration to Deliver and Evaluate a Pediatric Critical Care Simulation Curriculum for Emergency Medical Services |
| title_sort | statewide collaboration to deliver and evaluate a pediatric critical care simulation curriculum for emergency medical services |
| topic | simulation pediatric critical care prehospital resuscitation emergency medical services Emergency Medical Services for Children |
| url | https://www.frontiersin.org/articles/10.3389/fped.2022.903950/full |
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