Pediatric anesthesiology fellow education: is a simulation-based boot camp feasible and valuable?

Paediatr Anaesth. 2016 May;26(5):481-7. doi: 10.1111/pan.12865. Epub 2016 Mar 7.

Abstract

Background: Pediatric anesthesiologists must manage crises in neonates and children with timely responses and limited margin for error. Teaching the range of relevant skills during a 12-month fellowship is challenging. An experiential simulation-based curriculum can augment acquisition of knowledge and skills.

Objectives: To develop a simulation-based boot camp (BC) for novice pediatric anesthesiology fellows and assess learner perceptions of BC activities. We hypothesize that BC is feasible, not too basic, and well received by fellows.

Methods: Skills stations, team-based in situ simulations, and group discussions of complex cases were designed. Stations were evaluated by anonymous survey; fellows rated usefulness in improving knowledge, self-confidence, technical skill, and clinical performance using a Likert scale (1 strongly disagree to 5 strongly agree). They were also asked if stations were too basic or too short. Median and interquartile range (IQR) data were calculated and noted as median (IQR).

Results: Fellows reported the difficult airway station and simulated scenarios improved knowledge, self-confidence, technical skill, and clinical performance. They disagreed that stations were too basic or too short with exception of the difficult airway session, which was too short [4 (4-3)]. Fellows believed the central line station improved knowledge [4 (4-3)], technical skills [4 (4-4)], self-confidence [4 (4-3)], and clinical performance [4 (4-3)]; scores trended toward neutral likely because the station was perceived as too basic [3.5 (4-3)]. An interactive session on epinephrine and intraosseous lines was valued. Complicated case discussion was of educational value [4 (5-4)], the varied opinions of faculty were helpful [4 (5-4)], and the session was neither too basic [2 (2-2)] nor too short [2 (2-2)].

Conclusion: A simulation-based BC for pediatric anesthesiology fellows was feasible, perceived to improve confidence, knowledge, technical skills, and clinical performance, and was not too basic.

Keywords: education; graduate; leadership; medical; simulation; skills; teamwork.

MeSH terms

  • Airway Management
  • Anesthesiology / education*
  • Child
  • Child, Preschool
  • Clinical Competence
  • Curriculum
  • Education, Medical, Graduate
  • Epinephrine / therapeutic use
  • Faculty
  • Feasibility Studies
  • Humans
  • Infant
  • Infant, Newborn
  • Internship and Residency / methods*
  • Intubation, Intratracheal
  • Patient Simulation*
  • Pediatrics / education*
  • Vasoconstrictor Agents / therapeutic use

Substances

  • Vasoconstrictor Agents
  • Epinephrine