Spaced Scenario Demonstrations Improve Knowledge and Confidence in Pediatric Acute Illness Management

Overview

Journal Front Pediatr

Specialty Pediatrics

Date 2014 Dec 16

PMID 25505780

Citations 4

Authors

Rahul Ojha

Anthony Liu

Bernard Linton Champion

Emily Hibbert

Ralph Kay Heinrich Nanan

Affiliations

Soon will be listed here.

Abstract

Objectives: Nationally accredited simulation courses such as advance pediatric life support and pediatric advance life support are recommended for health care professionals (HCPs) at two yearly intervals as a minimum requirement, despite literature evidence suggesting rapid decline in knowledge shortly after course completion. The objective of this study was to evaluate an observation-based, educational intervention program aimed at improving previously acquired knowledge and confidence in managing critical illnesses.

Methods: A prospective cohort longitudinal study was conducted over a 6-month period. Participants were assessed with a knowledge based questionnaire immediately prior to and after observing 12 fortnightly critical illness scenario demonstrations (CISDs). The outcome measure was performance on questionnaires. Regression analysis was used to adjust for potential confounders. Questionnaire practice effect was evaluated on 30 independent HCPs not exposed to the CISDs.

Results: Fifty-four HCPs (40 doctors and 14 nurses) participated in the study. All participants had previously attended nationally accredited simulation courses with a mean time since last attendance of 1.8 ± 0.4 years. The median number of attendances at CISD was 6 (2-12). The mean questionnaire scores at baseline (17.2/25) were significantly lower than the mean post intervention questionnaire scores (20.3/25), p = 0.003. The HCPs self-rated confidence in managing CISD was 6.5 times higher at the end of the program in the intervention group (p = 0.002) than at baseline. There was no practice effect for questionnaires demonstrated in the independent sample.

Conclusion: The educational intervention program significantly improved the knowledge and confidence of the participants in managing pediatric critical illnesses. The CISD program provides an inexpensive, practical, and time effective method of facilitating knowledge acquisition and retention. Despite the distinctively different approach, this study has shown the effectiveness of the participant being an observer to enhance pediatric resuscitation skills.

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References

Okuda Y, Bryson E, DeMaria Jr S, Jacobson L, Quinones J, Shen B . The utility of simulation in medical education: what is the evidence?. Mt Sinai J Med. 2009; 76(4):330-43. DOI: 10.1002/msj.20127. View

van Schaik S, Plant J, Diane S, Tsang L, OSullivan P . Interprofessional team training in pediatric resuscitation: a low-cost, in situ simulation program that enhances self-efficacy among participants. Clin Pediatr (Phila). 2011; 50(9):807-15. DOI: 10.1177/0009922811405518. View

Grant E, Marczinski C, Menon K . Using pediatric advanced life support in pediatric residency training: does the curriculum need resuscitation?. Pediatr Crit Care Med. 2007; 8(5):433-9. DOI: 10.1097/01.PCC.0000282044.78432.0B. View

Zendejas B, Brydges R, Wang A, Cook D . Patient outcomes in simulation-based medical education: a systematic review. J Gen Intern Med. 2013; 28(8):1078-89. PMC: 3710391. DOI: 10.1007/s11606-012-2264-5. View

Bloch S, Bloch A . Simulation training based on observation with minimal participation improves paediatric emergency medicine knowledge, skills and confidence. Emerg Med J. 2013; 32(3):195-202. DOI: 10.1136/emermed-2013-202995. View

Kerfoot B . Adaptive spaced education improves learning efficiency: a randomized controlled trial. J Urol. 2009; 183(2):678-81. DOI: 10.1016/j.juro.2009.10.005. View

Berden H, Willems F, Hendrick J, Pijls N, Knape J . How frequently should basic cardiopulmonary resuscitation training be repeated to maintain adequate skills?. BMJ. 1993; 306(6892):1576-7. PMC: 1677995. DOI: 10.1136/bmj.306.6892.1576. View

Kerfoot B, DeWolf W, Masser B, Church P, Federman D . Spaced education improves the retention of clinical knowledge by medical students: a randomised controlled trial. Med Educ. 2007; 41(1):23-31. DOI: 10.1111/j.1365-2929.2006.02644.x. View

Kurosawa H, Ikeyama T, Achuff P, Perkel M, Watson C, Monachino A . A randomized, controlled trial of in situ pediatric advanced life support recertification ("pediatric advanced life support reconstructed") compared with standard pediatric advanced life support recertification for ICU frontline providers*. Crit Care Med. 2013; 42(3):610-8. DOI: 10.1097/CCM.0000000000000024. View

10.

Kerfoot B, Baker H, Koch M, Connelly D, Joseph D, Ritchey M . Randomized, controlled trial of spaced education to urology residents in the United States and Canada. J Urol. 2007; 177(4):1481-7. DOI: 10.1016/j.juro.2006.11.074. View

11.

Tofil N, Morris J, Peterson D, Watts P, Epps C, Harrington K . Interprofessional simulation training improves knowledge and teamwork in nursing and medical students during internal medicine clerkship. J Hosp Med. 2014; 9(3):189-92. DOI: 10.1002/jhm.2126. View

12.

Glenberg A, Lehmann T . Spacing repetitions over 1 week. Mem Cognit. 1980; 8(6):528-38. DOI: 10.3758/bf03213772. View

13.

Waisman Y, Amir L, Mor M, Mimouni M . Pediatric advanced life support (PALS) courses in Israel: ten years of experience. Isr Med Assoc J. 2005; 7(10):639-42. View

14.

Donoghue A, Durbin D, Nadel F, Stryjewski G, Kost S, Nadkarni V . Effect of high-fidelity simulation on Pediatric Advanced Life Support training in pediatric house staff: a randomized trial. Pediatr Emerg Care. 2009; 25(3):139-44. DOI: 10.1097/PEC.0b013e31819a7f90. View

15.

Morris P, Fritz C . The improved name game: better use of expanding retrieval practice. Memory. 2002; 10(4):259-66. DOI: 10.1080/09658210143000371. View

16.

Jewkes F, Phillips B . Resuscitation training of paediatricians. Arch Dis Child. 2003; 88(2):118-21. PMC: 1719456. DOI: 10.1136/adc.88.2.118. View

17.

Issenberg S, McGaghie W, Petrusa E, Gordon D, Scalese R . Features and uses of high-fidelity medical simulations that lead to effective learning: a BEME systematic review. Med Teach. 2005; 27(1):10-28. DOI: 10.1080/01421590500046924. View

18.

Skidmore M, Urquhart H . Retention of skills in neonatal resuscitation. Paediatr Child Health. 2010; 6(1):31-5. PMC: 2804451. DOI: 10.1093/pch/6.1.31. View

19.

Fischer H, Strunk G, Neuhold S, Kiblbock D, Trimmel H, Baubin M . The effectiveness of ERC advanced life support (ALS) provider courses for the retention of ALS knowledge. Resuscitation. 2011; 83(2):227-31. DOI: 10.1016/j.resuscitation.2011.09.014. View

20.

Kerfoot B, Brotschi E . Online spaced education to teach urology to medical students: a multi-institutional randomized trial. Am J Surg. 2008; 197(1):89-95. DOI: 10.1016/j.amjsurg.2007.10.026. View