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High-Yield Facts

  • Simulation provides a safe, risk-free, experiential learning environment where emergency department (ED) practitioners can hone their skills with no potential for adverse consequences to real patients.

  • The acquisition and retention of skills requires hands-on practice complemented by feedback and robust assessments. However, external forces have significantly reduced the number of opportunities to practice procedures in the ED and tolerance for medical errors. Simulation can be used to provide these experiences “on-demand.”

  • Effective simulation-based training interventions have a range of difficulty customized to the individual practitioner's skill level.

  • Postgraduate medical education systems in the United States, Canada, and United Kingdom have called for competency-based education with focused and rigorous evaluations. Mastery learning is a form of competency-based education in which training continues until the participant achieves a uniform level of skill mastery as measured by rigorous standards.

  • The extended duration between performance of many pediatric emergency medicine (PEM) skills leads to deterioration in even the most expert providers. Just-in-time (JIT) training is a training scheme in which the required knowledge and skills are imparted for immediate application to avoid loss of retention due to a time gap.

Procedural Competency and Simulation

Simulation-based education (SBE) has seen rapid evolution with an increasing breadth of applications to pediatric emergency medicine (PEM).14 Educators have recognized that simulation can provide a safe, risk-free, experiential learning environment where emergency department (ED) practitioners can hone their skills with no potential for adverse consequences to real patients. PEM is an ideal field for applications of simulation as outcomes from pediatric cardiac arrest are poor, and traditional methods of resuscitation skills training lead to poor retention of knowledge and skills.5 This chapter describes how SBE is being: (a) integrated into PEM training programs; (b) utilized for crisis resource management (CRM) training for ED healthcare teams; (c) used to teach novel PEM topics; (d) explored as a potential tool for assessment of ED skills; and (e) used to enhance procedural skills competency for ED procedures.

Simulation-Based Education for PEM Training

Simulation has become an integral part of many PEM residency and fellowship training programs. SBE has been effectively integrated into pre-existing curriculum to better address PEM competencies and to provide trainees an opportunity to practice managing both common and rare conditions. Studies have shown that SBE improves the performance of emergency teams during simulated pediatric trauma resuscitations.2,6 The PEM training programs that have integrated simulation as a key learning modality have found that focused, frequent and effortful instructional interventions are necessary to achieve substantial performance improvements.3 A longitudinal approach to the integration of simulation into the PEM curriculum was described by Cheng et al.,4 where 43 different acute care scenarios, packaged as 12 different core and specialty modules, were delivered over 2 years of PEM training. Knowledge, technical skills, and behavioral skills were discussed and ...

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