596 - Development, Implementation and Evaluation of a Simulation Based Educational Curriculum for Pediatric Hospitalists

Poster Number: 596
Publication Number: 596.118

Lisa Carney, Children's Mercy Hospitals and Clinics, auburn, KS, United States; Kayla Heller, Children's Mercy Hospitals and Clinics, Kansas City, MO, United States; Matthew Hall, Children's Hospital Association, Lenexa, Kansas, KS, United States; Chris Kennedy, Children's Mercy Hospitals and Clinics, kansas city, MO, United States

Background: In 2010, Pediatric Hospital Medicine (PHM) core competencies were published. In response, our hospital medicine section and simulation program assessed and implemented simulation-based training to improve competency.

Objective: Our aim was to determine specific knowledge, skill and competency needs in alignment with our pediatric hospitalist scope of practice and evaluate the impact of a simulation-based training curriculum.

Design/Methods: A pre-post survey was administered to 48 physicians, providing self-ratings from Novice to Expert (5-point Likert scale) on published PHM competencies. We averaged participant responses on individual questions into domain scores on both pre and post simulation assessments. The mean change for each domain was assessed with a Sign-Rank test. Each participant was deemed competent in a domain if their mean score was three or greater. The change in competency status was determined using McNemar’s test. We determined if the change in score for each domain was different across years of experience or the number of sessions attended using Kruskal–Wallis tests.

Results: Survey response rate was 98% (pre), 79% (post). The median number of years of experience as an attending was 4 [IQR: 1-9]. Changes in mean scores and percent competent are presented in Table 2. On the pre-survey, areas with lowest self-reported competency (score < 3.1) included medically complex care, code cart, vascular access & medications, advanced airway management, and team communication. After implementation of the simulation curriculum designed to specifically address these gaps, there was significant improvement in scores for 5 of 9 domains and percent competent in one domain. Mean scores increased to three or greater in all domains reaching the designated self-assessment competency threshold. The change in scores was not associated with years of experience or with increased session attendance (range 3-6 sessions).Conclusion(s): Results from a baseline assessment were instrumental in designing a simulation-based faculty education curriculum. Post survey analysis revealed gains in multiple domains and identified future opportunities for targeted intervention to address persistent competency gaps. As new subspecialists, pediatric hospitalists across the county may find value in a similar process to provide novel faculty education.
Mean scores Pre & Post Intervention
Percent Competent Pre & Post