(898) Pediatric Rapid Response Training Through In Situ Simulation

Introduction: Many studies have outlined the effectiveness of simulation-based training for medical professionals. In-situ simulation provides training in real patient care environments and in real-time. This study will aim to introduce in-situ based skills training in rapid response scenarios for pediatric residents with the goal of improving comfort in running a rapid response team (RRT) and quality of RRTs in our children’s hospital.

Methods: Subjects consisted of 45 pediatric residents at Upstate Medical University. Each week, 4 residents were included in simulation sessions. Residents were not informed of the simulation in advance to adequately emulate a real-time rapid response. Residents were instructed to identify roles and respond as they would in a real patient encounter. Faculty then provided an extensive debrief. The study was conducted over a 6-month period, during which pre- and post-intervention surveys were conducted to assess change in resident confidence in running an RRT. A total of 31/45 residents completed the survey. A second survey was provided to 45 medical personnel, including residents, nurses, SWAT, and respiratory therapists to assess the change in quality of RRTs. The survey gauged whether distinct roles were identified at the start of an RRT, if they were well-organized or overcrowded, and whether the participants were satisfied with the outcome of RRTs. Two-tailed t-tests were then utilized to identify significant change.

Results: There was a significant increase in the residents' confidence to effectively run an RRT (p=0.002). Residents reported a significant improvement in their perception of having the medical knowledge required to run an RRT (p=0.001), and in their understanding of their roles and responsibilities during an RRT (p=0.001). Regarding the quality of rapid responses on the floor, there was a positive trend in all questions asked, however, results were not statistically significant.

Conclusions: In-situ simulation-based training provides a safe and effective way to train healthcare professionals. Based on pre- and post-simulation surveys, our study found a significant improvement in resident confidence in running RRTs. Additionally, there was a positive trend in the quality of RRTs following the study period, although not statistically significant.