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Impact of Simulation-Based Training on Perceived Provider Confidence in Acute Multidisciplinary Pediatric Trauma Resuscitation
Minna Wieck, MD, Alyssa Rake, MD, Rita V. Burke, PhD, MPH, Lissa C. Young, RN, BSN, CCRN, Todd P. Chang, MD, Elizabeth Cleek, RN, MS, CPNP, Inge Morton, RN, BSN, CPN, Catherine Goodhue MN, RN, CPNP, Jeffrey S. Upperman, MD and Aaron R. Jensen, MD, Med, Children's Hospital of Los Angeles, Los Angeles CA

Abstract:
Purpose:
Severely injured patients requiring rapid assessment and resuscitation are optimally treated by a well-functioning multidisciplinary trauma team. While these patients may present more commonly to adult trauma centers, they are somewhat rare at freestanding children's hospitals. Simulation-based training can improve team-based care at these centers. The purpose of this study was to assess the impact of simulation-based training on provider confidence in team-based management of these hyper-acute patients. Methods: Under IRB approval, four high-fidelity simulated traumatic cardiopulmonary arrests followed by structured debriefing were implemented in vivo with the on-call multidisciplinary trauma team over a period of two months in a freestanding children's hospital. All providers who are expected to respond to a trauma activation (n=190) were anonymously surveyed the month before (pre-) and the month after (post-) the simulations. Attitudes pre- and post-training were compared with Student's t-test. Results: 56 providers (MD, RN, RCP, PharmD, and Radiology Techs) participated in the training. Survey response rate was 47% (n=91/190) pre-intervention and 21% (n=40/190) post-intervention. Survey items with significant differences are tabulated in Table 1. Conclusions: Overall provider confidence decreased after simulation-based training. This suggests that high-stress simulations of severely injured patients may raise individual awareness to deficiencies in trauma team performance. Follow-up study after repeated simulation is warranted to see if provider confidence can be improved with ongoing training.
Table 1

Objective:
To identify the effect of simulation-based training on provider confidence in pediatric trauma resuscitation.
Objective Content:
Comparison of survey responses from multidisciplinary pediatric trauma team members obtained before and after four in vivo trauma simulations showed a significant decrease in provider confidence after simulation-based training.


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