Research Abstract Professor Rounds: Group 1 - Comparing Learning Outcomes in Emergency Medicine and Pediatric Emergency Medicine Faculty after Simulation (1090-004252)
Start time: Tuesday, January 26, 2021, 2:00 PM End time: Tuesday, January 26, 2021, 3:00 PM Session Type: Research Abstracts (Completed Studies)
Pediatric skills are a common focus for simulation-based training (SBT). Choosing appropriate learning objectives is critical in promoting positive learning outcomes. There are well-developed curricula that address appropriate needs in undergraduate and graduate medical education. For practicing physicians, there has been significant controversy in how to best guide lifelong learning – both for content and modality. Given the general success of SBT for a broad array of learners, it seems like it would also be an excellent platform for practicing physicians. However, there is a paucity of guidelines or curricula to help educators tailor content. Our objective was to explore the phenomena of learning outcomes in Emergency Medicine (EM) and Pediatric Emergency Medicine (PEM) Faculty after SBT, and also compare and contrast them as unique subsets of learners.
This was a qualitative study of EM and PEM faculty in an urban academic medical center. Groups of 3-5 faculty participated in 2 high fidelity scenarios in pairs or groups of 3. Two unique sessions were held. Session 1 focused on neonatal resuscitation and infant respiratory failure, while session 2 focused on head trauma secondary to non-accidental trauma (NAT) and neonatal shock secondary to congenital heart disease. Each scenario was debriefed by physicians with expertise in SBT. Following each session, faculty answered open-ended survey questions to describe action-oriented goals in neonatal care, infant airway management, general pediatric resuscitation, approach to pediatric head trauma, management of NAT, and approach to neonatal shock. Using a grounded theory approach, 3 study team members independently coded blinded responses to identify major themes (MT). They subsequently triangulated independently coded answers, while also looking for differences in EM and PEM responses.
A total of 47 EM and 9 PEM faculty participated, with a subset of 19 participating in both sessions. 21 major themes (MT) were derived. MT related to neonatal care: Neonatal Resuscitation Program (NRP), checking glucose, beginning resuscitation with room air oxygen, calling for help early, and the importance of heart rate in assessing clinical status. MT for infant airway management: stepwise approach to escalating therapy. MT around general resuscitative skills: expanding pediatric knowledge, gaining more procedural experience, accessible pediatric resources such as smartphone applications, more clinical experience, and more SIM. MT for pediatric head trauma: airway management, pharmacologic management of intracranial pressure, thorough physical exam, and considering NAT on a broad differential. MT for pediatric NAT: importance of thorough physical exam, calling child protective services, considering NAT as part of a broad differential, and remaining non-judgmental toward caregivers.
Both EM and PEM Faculty had numerous action oriented learning goals after SIM, with many overlapping themes. However, there were a few notable differences. EM Faculty focused more on general medical knowledge, whereas PEM Faculty wanted more procedural experience. No PEM stated a need to call for early help (in general or for specific support resources like child protective services), a need for immediately accessible knowledge resources like a smartphone app, or need to improve upon their physical exam. We actively used this data to help guide internal initiatives (e.g. more scenario based sessions for EM to support general knowledge and dedicated procedural based sessions for PEM). Codifying these needs are ultimately important, as practicing physicians are less likely to buy in to learning programs if they do not feel they are relevant. In general, we did find that Faculty enjoyed SBT as a learning modality, and were eager to return for additional sessions.