Learning to Beat the Shock Clock: A Low-Fidelity Simulation Board Game for Pediatric and Emergency Medicine Residents

MedEdPORTAL. 2019 Feb 11:15:10804. doi: 10.15766/mep_2374-8265.10804.

Abstract

Introduction: Resident physicians may have difficulty with identifying and managing pediatric septic shock due to limited patient encounters. Simulation-based interventions can enhance competency. We developed a low-fidelity tabletop simulation game to teach pediatric septic shock and compared residents' knowledge of and comfort with recognition and management of septic shock.

Methods: Pediatric and emergency medicine residents participated in an education session involving a low-fidelity, tabletop simulation in which they managed two simulated pediatric patients with septic shock. The two patients were a 12-year-old healthy male with cold shock due to a urinary tract infection and a 5-year-old female with a history of leukemia who developed warm shock due to pneumonia. Because this session was presented as a board game rather than high-fidelity simulation, learners focused on decision making rather than the mechanics of procedures. Residents completed a survey and a knowledge-based test before and after this session.

Results: Twenty-three pediatric and nine emergency medicine residents participated. Correct responses for the preintervention test were 71%, compared with 83% postintervention. The difference in rates was 12% (95% confidence interval, -0.17 to -0.07; p < .0001). Residents rated this modality as being more useful than lectures or reading and as equivalent to bedside teaching and high-fidelity simulation.

Discussion: Our pilot low-fidelity simulation improved resident knowledge and comfort with pediatric septic shock care. Further studies are needed to address the impact of low-fidelity simulations on patient outcomes.

Keywords: Low-Fidelity Simulation; Pediatric Sepsis; Residents; Septic Shock; Severe Sepsis.

Publication types

  • Case Reports
  • Comparative Study

MeSH terms

  • Child
  • Child, Preschool
  • Clinical Competence
  • Emergency Medicine / education*
  • Female
  • Games, Recreational
  • Humans
  • Internship and Residency / methods*
  • Knowledge
  • Learning / physiology
  • Leukemia / complications
  • Male
  • Pediatrics / education*
  • Pneumonia / complications
  • Shock, Septic / diagnosis
  • Shock, Septic / etiology*
  • Shock, Septic / therapy
  • Simulation Training / methods
  • Urinary Tract Infections / complications