PM2102: Introduction of Role Modeling Simulation Sessions to Help Improve the Competency, Comfort, Practice, and Delivery of Safe Sleep Recommendations in Pediatric Residents

Background: Safe sleep practices recommended by the American Academy of Pediatrics (AAP) include placing infants to sleep on their backs, room sharing but not bed sharing, and keeping a sleep area free of loose bedding. Hospitals can become leaders in protecting infants and reducing sleep-related deaths as they reach new parents. However, studies have shown that more than half of providers do not consistently recommend safe sleep practices in the hospital, thus creating a disconnect between what parents are told and what they observe. Role modeling has shown to increase adherence to safe sleep guidelines. Simulation has been shown to be an effective tool in teaching communication strategies. The objective of this study is to establish an educational intervention that helps improve the competency, comfort, practice, and delivery of safe sleep recommendations as part of the “Safe Sleep for Brooklyn Babies: Identifying and overcoming Disparities in Infant Safe Sleep Practices” study.

Methods: A proctored baseline survey related to safe sleep and Sudden Unexpected Infant Death (SUID) risk-reduction was provided to pediatric residents and staff. This was followed by a role modeling simulation activity (figure 1) where residents were tasked to provide a counseling session to a new mother addressing SUID/Sudden Infant Death Syndrome (SIDS) risk factors, the ABCs of Safe Sleep and AAP guidelines. After an individual debriefing session where the counseling points and baseline survey were reviewed, residents repeated the counseling session using the new information and tools learned. A 10-item grading rubric (1 = lowest, 10 = highest) was used in both initial and post-debrief sessions. Residents also provided their confidence levels after each pre-and post-simulation activity.

Results: Fifty-three providers completed the survey and 17 residents completed the role modeling session. Most respondents were female (73.76%), residents (66.04%), aged 31-40 (41.5%), employed at Brookdale Hospital for ≤2 years (52.8%). The survey had a mean score of 75.34%. Most missed questions were related to the epidemiology of SIDS/SUID (32.1% correct), impact of the Back to Sleep Campaign (66% correct), and risk factors such as smoking (62.3% correct)(table 1a). From the simulation activity, total scores increased by 2.4 points, and confidence scores by 2.3 points (p = < 0.001). Recommendations such as using a mattress with snug fit, using wearable blankets/not loose bedding, and using teach-back methods, had the greatest statistically significant increase in mean scores (.529, .529, and .412) (p = < 0.05) (table 1b).

Conclusion: Providing role modeling sessions has the potential to improve residents’ confidence and perceived comfort in counseling patients on SIDS/SUID prevention. Further studies are needed to determine if they improve practices and self-efficacy in the mothers receiving these messages. Continued assessments using other pediatric topics are needed to determine the intervention’s effectiveness in improving communication skills.