PC3116: A Virtual Simulation Curriculum Improves Resident Participation in Pediatric Mock Codes

Purpose/Objectives: Most pediatric residents finish their training without attaining sufficient knowledge and experience to confidently provide comprehensive care to pediatric patients in cardiopulmonary arrest. Residents infrequently lead or participate in real or mock resuscitations. In our residency program, a survey identified that pediatric residents had limited participation in resuscitation events, simulated or real, with few ever leading one, and overall poor retention of PALS knowledge despite being certified in PALS. To address these concerns, we developed a formalized virtual and hybrid simulation curriculum amidst the COVID-19 pandemic. A completely virtual simulation was created using a mobile application called SimMon. As the COVID pandemic eased, we implemented at hybrid model where a few residents participated in-person, and other learners including the team leader participated virtually. Using this formalized virtual and hybrid simulation curriculum, we aimed to improve resident participation in mock codes, PALS knowledge retention and overall confidence in performing a pediatric resuscitation.

Design/Methods: From February 2021 to February 2022, we implemented our curriculum with both virtual and hybrid simulations occurring every other month. We conducted an online survey designed to assess resident participation in resuscitations, their confidence levels in performing a pediatric resuscitation and cognitive knowledge in PALS at 0, 6, and 12 month points during the study time. In the first part of the survey, residents assessed their confidence levels in 4 general skills on a 5 point Likert scale. To test their theoretical knowledge, all residents were given a multiple choice test. Contingency table and Fisher’s exact test were used to examine the association of categorical survey questions with data collection time. Analysis of variance (ANOVA) was used to compare the average level of agreement for each Likert-scale question across three time points.

Results: Among the 32 study participants, only 47% had participated in a simulation prior to the study; this improved to 79% of residents by 12 months. Only 6% had led a simulation, which was increased to 64% at the end of the study. Residents felt more confident in their ability to get help (p =0.04) and their ability to be a team leader (p < 0.001), both of which were statistically significant. There was no difference in their confidence in recognizing hemodynamic instability (p =0.25) or their ability to delegate tasks (p =0.092). The average level of PALS retention showed an increased trend throughout the study time period (p=0.065).

Conclusion/Discussion: Simulation curriculum utilizing a virtual platform can lead to increased resident participation in resuscitation, which may translate to improved confidence in performing a pediatric resuscitation. There may also be some benefit with PALS knowledge retention. Similar curricula utilizing virtual platforms can have a role post-pandemic as they can enable educators to overcome barriers in resident participation.