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Pediatr Surg Int. 2018 Dec;34(12):1353-1362. doi: 10.1007/s00383-018-4361-y. Epub 2018 Oct 15.

Impact of simulation-based training on perceived provider confidence in acute multidisciplinary pediatric trauma resuscitation.

Author information

1
Division of Pediatric Surgery, Children's Hospital Los Angeles and the Keck School of Medicine of the University of Southern California, Mailstop 100, 4650 Sunset Blvd, Los Angeles, CA, 90027, USA.
2
Trauma Program, Children's Hospital Los Angeles and the Keck School of Medicine of the University of Southern California, Los Angeles, CA, 90027, USA.
3
Division of Anesthesiology and Critical Care Medicine, Children's Hospital Los Angeles and the Keck School of Medicine of the University of Southern California, Los Angeles, CA, 90027, USA.
4
Division of Emergency and Transport Medicine, Children's Hospital Los Angeles and the Keck School of Medicine of the University of Southern California, Los Angeles, CA, 90027, USA.
5
Division of Trauma and Burn Surgery, Children's National Medical Center, Washington, DC, 20010, USA.
6
Division of Pediatric Surgery, Children's Hospital Los Angeles and the Keck School of Medicine of the University of Southern California, Mailstop 100, 4650 Sunset Blvd, Los Angeles, CA, 90027, USA. ajensen@chla.usc.edu.
7
Trauma Program, Children's Hospital Los Angeles and the Keck School of Medicine of the University of Southern California, Los Angeles, CA, 90027, USA. ajensen@chla.usc.edu.

Abstract

PURPOSE:

Simulation-based training has the potential to improve team-based care. We hypothesized that implementation of an in situ multidisciplinary simulation-based training program would improve provider confidence in team-based management of severely injured pediatric trauma patients.

METHODS:

An in situ multidisciplinary pediatric trauma simulation-based training program with structured debriefing was implemented at a free-standing children's hospital. Trauma providers were anonymously surveyed 1 month before (pre-), 1 month after (post-), and 2 years after implementation.

RESULTS:

Survey response rate was 49% (n = 93/190) pre-simulation, 22% (n = 42/190) post-simulation, and 79% (n = 150/190) at 2-year follow-up. These providers reported more anxiety (p = 0.01) and less confidence (p = 0.02) 1-month post-simulation. At 2-year follow-up, trained providers reported less anxiety (p = 0.02) and greater confidence (p = 0.01), compared to untrained providers.

CONCLUSIONS:

Implementation of an in situ multidisciplinary pediatric trauma simulation-based training program may initially lead to increased anxiety, but long-term exposure may lead to greater confidence.

LEVEL OF EVIDENCE:

II, Prospective cohort.

KEYWORDS:

Communication; Confidence; Pediatric trauma; Simulation; Teamwork

PMID:
30324569
DOI:
10.1007/s00383-018-4361-y
[Indexed for MEDLINE]

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