“When in Doubt, Change It out”: A Case-Based Simulation for Pediatric Residents Caring for Hospitalized Tracheostomy-Dependent Children
Introduction Caring for technology-dependent children, such as those with tracheostomy and ventilator dependence, can be new and frightening for pediatric residents. Education about emergencies in this patient population is important because these children are at risk for in-hospital complications....
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| Format: | Article |
| Language: | English |
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Association of American Medical Colleges
2020-10-01
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| Series: | MedEdPORTAL |
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| Online Access: | http://www.mededportal.org/doi/10.15766/mep_2374-8265.10994 |
| _version_ | 1818913558948216832 |
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| author | Erin K. Khan Tai M. Lockspeiser Deborah R. Liptzin Maxene Meier Christopher D. Baker |
| author_facet | Erin K. Khan Tai M. Lockspeiser Deborah R. Liptzin Maxene Meier Christopher D. Baker |
| author_sort | Erin K. Khan |
| collection | DOAJ |
| description | Introduction Caring for technology-dependent children, such as those with tracheostomy and ventilator dependence, can be new and frightening for pediatric residents. Education about emergencies in this patient population is important because these children are at risk for in-hospital complications. Safe care of the tracheostomy-dependent child requires the ability to recognize common complications, such as tracheostomy tube obstruction or decannulation, and intervene appropriately by suctioning and/or replacing the tracheostomy tube. This simulation-based curriculum teaches learners to identify and practice the management of these tracheostomy tube complications through low-fidelity simulation exercises. Methods We created a simulation session with three cases reflecting in-hospital scenarios encountered by resident physicians caring for tracheostomy-dependent children in the inpatient setting. The simulation scenario, simulation environment preparation, materials list, and debriefing outline are provided for the instructor for each simulation case. Validity evidence for the assessment tool was obtained by calculating the interrater reliability of two different raters. Resident feedback was obtained through anonymous surveys. Results Twelve pediatric senior residents completed the experience. It received overwhelmingly positive feedback on learner evaluation forms, with 90% finding the experience very or extremely helpful. The intraclass correlation coefficient of interrater reliability for our assessment tool was 0.93. Discussion The simulation was well received by residents. The interrater reliability was acceptable. This low-fidelity simulation exercise can easily be executed with minimal materials or instructor training. High-yield, just-in-time training with postcase debriefing is key to the simulation's success. |
| first_indexed | 2024-12-19T23:32:24Z |
| format | Article |
| id | doaj.art-c914fc5d88e742f8a93803850e386370 |
| institution | Directory Open Access Journal |
| issn | 2374-8265 |
| language | English |
| last_indexed | 2024-12-19T23:32:24Z |
| publishDate | 2020-10-01 |
| publisher | Association of American Medical Colleges |
| record_format | Article |
| series | MedEdPORTAL |
| spelling | doaj.art-c914fc5d88e742f8a93803850e3863702022-12-21T20:01:41ZengAssociation of American Medical CollegesMedEdPORTAL2374-82652020-10-011610.15766/mep_2374-8265.10994“When in Doubt, Change It out”: A Case-Based Simulation for Pediatric Residents Caring for Hospitalized Tracheostomy-Dependent ChildrenErin K. Khan0Tai M. Lockspeiser1Deborah R. Liptzin2Maxene Meier3Christopher D. Baker4Fellow, Department of Pediatrics, Section of Pulmonology and Sleep Medicine, University of Colorado School of MedicineAssociate Professor, Department of Pediatrics, University of Colorado School of Medicine; Assistant Dean of Medical Education, University of Colorado School of MedicineAssistant Professor, Department of Pediatrics, Section of Pulmonology and Sleep Medicine, University of Colorado School of MedicineResearch Instructor, Department of Pediatrics, University of Colorado School of MedicineAssociate Professor, Department of Pediatrics, Section of Pulmonology and Sleep Medicine, University of Colorado School of Medicine; Director of Ventilator Care Program, University of Colorado School of MedicineIntroduction Caring for technology-dependent children, such as those with tracheostomy and ventilator dependence, can be new and frightening for pediatric residents. Education about emergencies in this patient population is important because these children are at risk for in-hospital complications. Safe care of the tracheostomy-dependent child requires the ability to recognize common complications, such as tracheostomy tube obstruction or decannulation, and intervene appropriately by suctioning and/or replacing the tracheostomy tube. This simulation-based curriculum teaches learners to identify and practice the management of these tracheostomy tube complications through low-fidelity simulation exercises. Methods We created a simulation session with three cases reflecting in-hospital scenarios encountered by resident physicians caring for tracheostomy-dependent children in the inpatient setting. The simulation scenario, simulation environment preparation, materials list, and debriefing outline are provided for the instructor for each simulation case. Validity evidence for the assessment tool was obtained by calculating the interrater reliability of two different raters. Resident feedback was obtained through anonymous surveys. Results Twelve pediatric senior residents completed the experience. It received overwhelmingly positive feedback on learner evaluation forms, with 90% finding the experience very or extremely helpful. The intraclass correlation coefficient of interrater reliability for our assessment tool was 0.93. Discussion The simulation was well received by residents. The interrater reliability was acceptable. This low-fidelity simulation exercise can easily be executed with minimal materials or instructor training. High-yield, just-in-time training with postcase debriefing is key to the simulation's success.http://www.mededportal.org/doi/10.15766/mep_2374-8265.10994TracheostomySimulationPediatricsLow FidelityPulmonologyClinical Reasoning/Diagnostic Reasoning |
| spellingShingle | Erin K. Khan Tai M. Lockspeiser Deborah R. Liptzin Maxene Meier Christopher D. Baker “When in Doubt, Change It out”: A Case-Based Simulation for Pediatric Residents Caring for Hospitalized Tracheostomy-Dependent Children MedEdPORTAL Tracheostomy Simulation Pediatrics Low Fidelity Pulmonology Clinical Reasoning/Diagnostic Reasoning |
| title | “When in Doubt, Change It out”: A Case-Based Simulation for Pediatric Residents Caring for Hospitalized Tracheostomy-Dependent Children |
| title_full | “When in Doubt, Change It out”: A Case-Based Simulation for Pediatric Residents Caring for Hospitalized Tracheostomy-Dependent Children |
| title_fullStr | “When in Doubt, Change It out”: A Case-Based Simulation for Pediatric Residents Caring for Hospitalized Tracheostomy-Dependent Children |
| title_full_unstemmed | “When in Doubt, Change It out”: A Case-Based Simulation for Pediatric Residents Caring for Hospitalized Tracheostomy-Dependent Children |
| title_short | “When in Doubt, Change It out”: A Case-Based Simulation for Pediatric Residents Caring for Hospitalized Tracheostomy-Dependent Children |
| title_sort | when in doubt change it out a case based simulation for pediatric residents caring for hospitalized tracheostomy dependent children |
| topic | Tracheostomy Simulation Pediatrics Low Fidelity Pulmonology Clinical Reasoning/Diagnostic Reasoning |
| url | http://www.mededportal.org/doi/10.15766/mep_2374-8265.10994 |
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