601 - Implementing and evaluating a senior resident led nighttime urgent event simulation curriculum

Poster Number: 601
Publication Number: 601.118

Amanda Rogers, Medical College of Wisconsin, Milwaukee, WI, United States; Svetlana Melamed, Medical College of Wisconsin, Milwaukee, WI, United States; Swathi Prasad, Medical College of Wisconsin, Wauwatosa, WI, United States; Krista Parran, MCWAH, Milwaukee, WI, United States; Abigail Schuh, Medical College of Wisconsin, Menomonee Falls, WI, United States

Background: Pediatric interns are often the first to respond to urgent clinical events but lack confidence and consistent training in urgent management skills which can negatively impact patient care. Simulation education can improve urgent event management but requires trained facilitators and learner time. Night rotations often lack structured education. A senior resident led (SL) night urgent event simulation (UES) curriculum may address both areas, providing a feasible way to conduct UES and filling a known educational gap at night.

Objective: To implement a SL night UES curriculum and assess its impact on night education frequency and intern confidence managing urgent events.

Design/Methods: We developed five UES toolkits, one for each of our acute care teams, contained a scenario addressing initial management of an urgent event, relevant supplies, and a debriefing guide. We also developed a Residents as Educators workshop including debriefing best practices to prepare seniors to facilitate UES. We first implemented UES as faculty-led (FL) day sessions and expanded to SL night UES with seniors facilitating UES for interns. Interns completed the Satisfaction with Simulation Experience Survey (SSES) and reported confidence managing urgent events on a 5-point Likert scale pre/post UES. Qualitative data through an open-ended survey assessed lessons learned. Mann Whitney U assessed for changes in intern confidence pre/post sessions and between SL and FL sessions. Qualitative content analysis identified themes for lessons learned.

Results: We conducted 46 day FL and 56 night SL UES. There was an increase in frequency of night education following implementation of SL night UES. All sessions were well received (median 5/5 on SSES). No participants reported UES interfered with clinical duties. Intern confidence managing urgent events improved following UES (pre median 3, interquartile range (IQR) 2-3, post 4, IQR 4-5, p<0.001). Similar improvements were seen for both SL and FL UES with no difference in post confidence between the two groups (FL 4; SL 4, p=0.9).
Qualitative analysis identified three themes of lessons learned: communication skills, clinical knowledge, and resources/logistics. Lessons from FL sessions related to all three themes equally, while SL sessions focused primarily on clinical knowledge.Conclusion(s): SL night UES are a feasible method to increase night education and are associated with improved intern confidence managing urgent events. Next steps include assessing for change in senior facilitators’ confidence managing urgent events and resident urgent event management in the clinical environment.