Integrating Leadership into Interprofessional Non-acute Care Pediatric Provider Resuscitation Training

Overview

Journal J Clin Transl Res

Date 2022 Dec 1

PMID 36452004

Authors

Ronish Gupta

Christina Toppozini

Thomas J Caruso

Anna-Theresa Lobos

Affiliations

Soon will be listed here.

Abstract

Background And Aim: Due to limited clinical exposure, non-acute care pediatric providers often rely on simulated experiences to maintain resuscitation skills. Few training options designed for the non-acute care setting exist, are often difficult to access, and lack incorporation of non-technical skills. The first five minutes (FFM) is a previously published curriculum designed to train non-acute care providers. The goal of this study was to determine the curriculum's effectiveness during a pilot intervention.

Methods: A single cohort of multi-professional, non-acute care pediatric providers participated. The primary outcome skill was "establishing leadership," and secondary outcomes included other technical and non-technical skills. Learning of outcome skills was assessed using changes in retrospective pre-post self-assessment Likert scale scores. Differences were compared using paired t-tests and ANOVA.

Results: Thirty-seven participants submitted self-assessments. There was improvement in establishing leadership (pre-mean 1.14, post-mean 2.30, P < 0.01), and all other objectives studied. Compared to each other, subgroups of nurses, physicians, and respiratory therapists demonstrated significant differences in learning of technical skills, but similar improvements with non-technical skills.

Conclusion: These findings suggest that the FFM curriculum is an effective tool for training non-acute care pediatric providers interprofessional resuscitation skills. Future research should assess provider behavioral changes, retention of training requirements, and patient outcomes.

Relevance For Patients: Traditional resuscitation education programs focus largely, or entirely, on performance of technical skills and algorithmic actions. However, non-technical skills, such as leadership, are crucial to the overall success of resuscitation efforts. The FFM program was developed to incorporate leadership principles into the resuscitation education of non-acute care pediatric inpatient providers, and this curricular evaluation suggests that improvements in participant leadership skills occurred due to the program.

References

Cheng A, Magid D, Auerbach M, Bhanji F, Bigham B, Blewer A . Part 6: Resuscitation Education Science: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2020; 142(16_suppl_2):S551-S579. DOI: 10.1161/CIR.0000000000000903. View

Bhanji F, Gottesman R, de Grave W, Steinert Y, Winer L . The retrospective pre-post: a practical method to evaluate learning from an educational program. Acad Emerg Med. 2012; 19(2):189-94. DOI: 10.1111/j.1553-2712.2011.01270.x. 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

Topjian A, Raymond T, Atkins D, Chan M, Duff J, Joyner Jr B . Part 4: Pediatric Basic and Advanced Life Support: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2020; 142(16_suppl_2):S469-S523. DOI: 10.1161/CIR.0000000000000901. View

Grimsley E, Cochrane N, Keane R, Sumner B, Mullan P, OConnell K . A Pulse Check on Leadership and Teamwork: An Evaluation of the First 5 Minutes of Emergency Department Resuscitation During Pediatric Cardiopulmonary Arrests. Pediatr Emerg Care. 2019; 37(12):e1122-e1127. DOI: 10.1097/PEC.0000000000001923. 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

McCrory M, Aboumatar H, Custer J, Yang C, Hunt E . "ABC-SBAR" training improves simulated critical patient hand-off by pediatric interns. Pediatr Emerg Care. 2012; 28(6):538-43. DOI: 10.1097/PEC.0b013e3182587f6e. View

Buyck M, Manzano S, Haddad K, Moncousin A, Galetto-Lacour A, Blondon K . Effects of Blindfold on Leadership in Pediatric Resuscitation Simulation: A Randomized Trial. Front Pediatr. 2019; 7:10. PMC: 6383074. DOI: 10.3389/fped.2019.00010. View

Sam J, Pierse M, Al-Qahtani A, Cheng A . Implementation and evaluation of a simulation curriculum for paediatric residency programs including just-in-time in situ mock codes. Paediatr Child Health. 2013; 17(2):e16-20. PMC: 3299361. DOI: 10.1093/pch/17.2.e16. View

10.

Lin Y, Cheng A, Grant V, Currie G, Hecker K . Improving CPR quality with distributed practice and real-time feedback in pediatric healthcare providers - A randomized controlled trial. Resuscitation. 2018; 130:6-12. DOI: 10.1016/j.resuscitation.2018.06.025. View

11.

Hunt E, Walker A, Shaffner D, Miller M, Pronovost P . Simulation of in-hospital pediatric medical emergencies and cardiopulmonary arrests: highlighting the importance of the first 5 minutes. Pediatrics. 2008; 121(1):e34-43. DOI: 10.1542/peds.2007-0029. View

12.

McCoy C, Rahman A, Rendon J, Anderson C, Langdorf M, Lotfipour S . Randomized Controlled Trial of Simulation vs. Standard Training for Teaching Medical Students High-quality Cardiopulmonary Resuscitation. West J Emerg Med. 2019; 20(1):15-22. PMC: 6324716. DOI: 10.5811/westjem.2018.11.39040. View

13.

Eppich W, Brannen M, Hunt E . Team training: implications for emergency and critical care pediatrics. Curr Opin Pediatr. 2008; 20(3):255-60. DOI: 10.1097/MOP.0b013e3282ffb3f3. View

14.

Cheng A, Lin Y, Nadkarni V, Wan B, Duff J, Brown L . The effect of step stool use and provider height on CPR quality during pediatric cardiac arrest: A simulation-based multicentre study. CJEM. 2017; 20(1):80-88. DOI: 10.1017/cem.2017.12. View

15.

Anderson R, Sebaldt A, Lin Y, Cheng A . Optimal training frequency for acquisition and retention of high-quality CPR skills: A randomized trial. Resuscitation. 2018; 135:153-161. DOI: 10.1016/j.resuscitation.2018.10.033. View

16.

Gupta R, Fitzgibbons C, Ramsay C, Vanderheiden L, Toppozini C, Lobos A . Development and pilot of an interprofessional pediatric resuscitation program for non-acute care inpatient providers. Med Educ Online. 2019; 24(1):1581521. PMC: 6394294. DOI: 10.1080/10872981.2019.1581521. View

17.

Hunziker S, Tschan F, Semmer N, Marsch S . Importance of leadership in cardiac arrest situations: from simulation to real life and back. Swiss Med Wkly. 2013; 143:w13774. DOI: 10.4414/smw.2013.13774. View

18.

Taras J, Everett T . Rapid Cycle Deliberate Practice in Medical Education - a Systematic Review. Cureus. 2017; 9(4):e1180. PMC: 5441688. DOI: 10.7759/cureus.1180. View

19.

Girotra S, Spertus J, Li Y, Berg R, Nadkarni V, Chan P . Survival trends in pediatric in-hospital cardiac arrests: an analysis from Get With the Guidelines-Resuscitation. Circ Cardiovasc Qual Outcomes. 2012; 6(1):42-9. PMC: 3555689. DOI: 10.1161/CIRCOUTCOMES.112.967968. View

20.

Famolare N, Romano J . The implementation of PEARS training: supporting nurses in non-critical care settings to improve patient outcomes. J Pediatr Nurs. 2012; 28(3):267-74. DOI: 10.1016/j.pedn.2012.05.005. View