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Am J Surg. 2019 Jan;217(1):180-185. doi: 10.1016/j.amjsurg.2018.06.009. Epub 2018 Jun 18.

Simulation-based training for trauma resuscitation among ACS TQIP-Pediatric centers: Understanding prevalence of use, associated center characteristics, training factors, and implementation barriers.

Author information

1
Department of Surgery, Children's Hospital Los Angeles and USC Keck School of Medicine, Los Angeles, CA, USA; Southern California Clinical and Translational Science Institute (SC-CTSI), Los Angeles, CA, USA. Electronic address: ajensen@chla.usc.edu.
2
Department of Surgery, Children's Hospital Los Angeles and USC Keck School of Medicine, Los Angeles, CA, USA. Electronic address: cmclaughlin@chla.usc.edu.
3
Department of Pediatrics, Children's Hospital Los Angeles and USC Keck School of Medicine, Los Angeles, CA, USA; Southern California Clinical and Translational Science Institute (SC-CTSI), Los Angeles, CA, USA. Electronic address: cawong@chla.usc.edu.
4
American College of Surgeons, Chicago, IL, USA. Electronic address: kathleen.mcauliff@einstein.yu.edu.
5
American College of Surgeons, Chicago, IL, USA; Department of Surgery, University of Toronto, Toronto, ON, Canada. Electronic address: anathens@facs.org.
6
Department of Surgery, Children's Hospital Los Angeles and USC Keck School of Medicine, Los Angeles, CA, USA. Electronic address: ebarin@chla.usc.edu.
7
Southern California Clinical and Translational Science Institute (SC-CTSI), Los Angeles, CA, USA; Department of Preventative Medicine, USC Keck School of Medicine, Los Angeles, CA, USA. Electronic address: dmeeker@usc.edu.
8
Department of Surgery, Children's Hospital Los Angeles and USC Keck School of Medicine, Los Angeles, CA, USA. Electronic address: hford@chla.usc.edu.
9
Division of Burn and Trauma Surgery, Children's National Medical Center, Washington, DC, USA. Electronic address: rburd@cnmc.org.
10
Department of Surgery, Children's Hospital Los Angeles and USC Keck School of Medicine, Los Angeles, CA, USA. Electronic address: jupperman@chla.usc.edu.

Abstract

BACKGROUND:

Simulation-based training (SBT) for pediatric trauma resuscitation can improve team performance. The purpose of this study was to describe the nationwide trend in SBT use and barriers to SBT implementation.

METHODS:

Trauma centers that participated in ACS TQIP Pediatric in 2016 (N = 125) were surveyed about SBT use. Center characteristics and reported implementation barriers were compared between centers using and not using SBT.

RESULTS:

Survey response rate was 75% (94/125) with 78% (73/94) reporting SBT use. The frequency of pediatric SBT use increased from 2014 to 2016 (median 5.5 vs 6.5 annual sessions, p < 0.01). Funding barriers were negatively associated with number of annual SBT sessions (r ≤ -0.34, p < 0.05). Centers not using SBT reported lack of technical expertise (p = 0.01) and lack of data supporting SBT (p = 0.03) as significant barriers.

CONCLUSIONS:

Simulation use increased from 2014 to 2016, but significant barriers to implementation exist. Strategies to share resources and decrease costs may improve usage.

LEVEL OF EVIDENCE:

Level 3, epidemiological.

KEYWORDS:

Barriers; Implementation; Pediatric trauma; Simulation; Simulation-based training; Trauma resuscitation

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