P0461 - Does rapid cycle deliberate practice during simulated emergencies improve perceived competency in pediatric residents?

Background:
Resuscitation during pediatric code events is a rare but important clinical experience during resident training. Simulation may be utilized as both a training and assessment tool in medical education to teach skills such as resuscitation, procedures, and team training. Rapid Cycle Deliberate Practice (RCDP) is a simulation-based training method that cycles between deliberate practice and directed feedback until mastery is achieved. Subjective and objective assessments of competencies required by The Accreditation Council for Graduate Medical Education (ACGME) for resident training using RCDP is limited.

Objective:
The aim of this study was to assess both subjective and objective resuscitation competency in pediatric residents in RCDP when compared with traditional simulation and reflective debriefing (RD).

Design/

Methods:
In this retrospective cohort study of prospectively collected data, pediatric residents participated in simulation code events throughout the academic year. Data collection took place from January 2016 to November 2019. RCDP was implemented into the curriculum in October 2016. Primary outcome measures included subjective assessment of competency, using both a self-assessment tool and the modified Tool for Resuscitation Assessment using Computerized Simulation (TRACS). Statistical analysis included chi-square test for categorical variables and Mann-Whitney U test for continuous variables.

Results:
A total of 459 surveys were completed by individual residents, representing 58 mock codes. Overall, residents reported agreement with perceived improvement in patient care (n=456, 99.6%), medical knowledge (n=452, 98.7%), communication skills (n=447, 97.2%), systems-based practice (n=440, 96.1%), and professionalism (n=420, 91.7%). Residents who participated in RCDP sessions reported higher agreement with comfort level (n=175, 49.9%, P=.04). There was no significant difference in overall objective resuscitation skills between the RCDP and RD group (P=.68), although performance variability decreased with RCDP.

Conclusion(s):
A simulation-based code blue curriculum may improve pediatric trainees’ perceptions of achieving ACGME competencies regardless of RCDP implementation. RCDP pediatric resuscitation training may increase resident comfort level in simulated emergencies, but its impact on objective performance measures is unclear when compared to RD. Further research should focus on the impact of an-RCDP-guided code blue curriculum on patient outcomes.