322 - Using Virtual Animated Simulations to Improve Pediatric Hospitalists’ Rapid Cardiopulmonary Assessment (RCPA) Skills and Comfort

Poster Number: 322

Lana Ismail, Children's National Health System, Arlington, VA, United States; Holly Bloom, Children's National Health System, Washington, DC, United States; Kevin M. Creamer, Children's National Health System, Silver Spring, MD, United States

Background: The rapid cardiopulmonary assessment (RCPA) is the approach recommended by the American Heart Association to assess decompensating children requiring resuscitation. Timely and comprehensive use of the RCPA aids pediatric hospitalists’ management of acutely ill children. The resuscitation literature shows practitioners’ performance of the RCPA and overall resuscitation skills need improvement.

Objective: Our goal was to improve the accuracy and speed with which pediatric hospitalists perform RCPAs in various scenarios. We also aimed to leverage innovative animated simulations to improve comfort with RCPA skills while the pandemic prevented live simulations.

Design/Methods: We created a virtual simulation session consisting of five progressively more complex scenarios and offered it serially between July and October 2021. Pediatric hospitalists in a large academic division voluntarily participated. Each scenario began with a summary of the patient’s presentation, a still image or animated video created in-house using Autodesk Maya and Adobe Photoshop software, and initial vital signs. (Figure 1) When the cases began, participants indicated which aspects of the exam they wanted, and the facilitator clicked on the image to reveal a pop-up description of the findings. Another facilitator completed a checklist for the RCPA (2 = correct, 1 = delayed or incomplete, & 0 = not done) and timed each performance. (Figure 2) After the first case, facilitators gave a brief tutorial on performing a timely yet comprehensive RCPA. After all scenarios and debriefings, participants were then asked to compare their comfort levels in performing the RCPA before and after the simulation.

Results: 31 of the 53 participants completed evaluations. On a 5-point Likert scale they rated the cases intellectually stimulating (4.94±0.25) and a valuable use of time (4.94±0.35). (Table 1) One way ANOVA comparing mean RCPA performance scores from case 1 to case 5 did not show significant improvement (p= 0.156). There was no correlation between score and time to completion found using Pearson correlation (p= 0.997).Conclusion(s): While virtual animated simulations increased pediatric hospitalist comfort levels with the RCPA, objective measures of completeness & timeliness showed no significant improvement. This may be due to the increasing difficulty of cases or may represent a gap between perceived and actual self-efficacy, highlighting the need for more robust objective data of knowledge transfer.
Figure 1: Congestive Heart Failure Scenario: Exam and Rapid Cardiopulmonary Assessment Scoring
Figure 2: Rapid Cardiopulmonary Assessment Exam Score Sheet