Clinical trial NCT01682629: Examining the Effect of a Scripted Debriefing on Resuscitation Performance in Pediatrics
Official title: Examining Pediatric Resuscitation Education Using Simulation and Scripted Debriefing: A Multicenter, Randomized Controlled Trial
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Pediatric Cardiac Arrest (Simulated)
Keywords: Pediatric
Cardiac
Arrest
Simulation
Debriefing
Realism
Lead sponsor: KidSIM Simulation Program
Sponsor class: NETWORK
Collaborators: name: American Heart Association
First posted: 2012-09-11
Enrollment: 443
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: FACTORIAL

Brief summary: The investigative team's purpose for conducting this research is to improve effective and efficient translation and implementation of evidence based advanced life support practice to providers of care for children. This specific project aims to accomplish 2 major goals. The investigators aim to evaluate the utility of a debriefing script specifically designed to facilitate debriefing when used by novice Pediatric Advanced Life Support instructors during low and high realism simulation-based learning. Secondly, the investigators hope to evaluate the effectiveness of high realism simulation vs. low realism simulation in achieving PALS-based educational outcomes, such as knowledge and skill acquisition.

The investigators hypothesize that SCRIPTED debriefing by novice instructors following low and high fidelity simulation-based learning will :

1. Improve the cognitive performance and knowledge of multidisciplinary team members as assessed by a cognitive performance tool and multiple choice testing compared with more traditional, NON-SCRIPTED debriefing;
2. Improve the behavioural, teamwork and communication skills of multidisciplinary team members as assessed by a validated assessment tool compared with more traditional, NON-SCRIPTED debriefing;

The investigators hypothesize that HIGH REALISM simulation-based learning will:

1. Improve the cognitive performance and knowledge of multidisciplinary team members as assessed by a cognitive performance tool and multiple choice testing compared with more traditional, LOW REALISM simulation;
2. Improve the behavioural, teamwork and communication skills of multidisciplinary team members as assessed by a validated assessment tool compared with more traditional, LOW REALISM simulation;


Eligibility criteria: Inclusion Criteria (Novice Instructors):

* senior residents (general pediatric, emergency medicine, pediatric subspecialty) in year three of training or above
* nursing staff, respiratory therapists or paramedics with greater than 5 years of clinical experience
* recent PALS certification within the past 2 years

Inclusion Criteria (Team composition)

* 1 or 2 pediatric nurses, 2 physicians (residents/fellows in pediatrics, anesthesia, family medicine, emergency medicine, pediatric emergency medicine, pediatric critical care or pediatric anesthesia) and/or 1 pediatric respiratory therapist or 1 pediatric transport paramedic

Exclusion Criteria (Novice Instructors):

* experienced instructors, defined as having taught three or more courses for healthcare professionals where simulation was followed by debriefing

Exclusion Criteria (Team composition)

* N/A

Primary outcomes:
measure: Behavioural Assessment Tool Score (Percentage 0-100%)
timeFrame: Baseline of one hour (post debreifing) - note: reporting change in timeframe for all 3 outcome measures
Secondary outcomes:
measure: Clinical Performance Tool Score (Percentage 0-100%)
timeFrame: Baseline of one hour (post debreifing) - note: reporting change in timeframe for all 3 outcome measures
measure: Multiple Choice Test (Knowledge)
timeFrame: Baseline of one hour (post debreifing) - note: reporting change in timeframe for all 3 outcome measures
Other outcomes:
Locations:
city: Vancouver
country: Canada
facility: BC Children's Hospital
state: British Columbia
Study officials:
affiliation: Children's Hospital of Philadelphia
name: Vinay Nadkarni, MD
role: STUDY_CHAIR
affiliation: Johns Hopkins University
name: Elizabeth Hunt, MD
role: STUDY_DIRECTOR
References:
citation: Hunt EA, Fiedor-Hamilton M, Eppich WJ. Resuscitation education: narrowing the gap between evidence-based resuscitation guidelines and performance using best educational practices. Pediatr Clin North Am. 2008 Aug;55(4):1025-50, xii. doi: 10.1016/j.pcl.2008.04.007.
citation: Eppich WJ, Adler MD, McGaghie WC. Emergency and critical care pediatrics: use of medical simulation for training in acute pediatric emergencies. Curr Opin Pediatr. 2006 Jun;18(3):266-71. doi: 10.1097/01.mop.0000193309.22462.c9.
citation: Eppich WJ, Brannen M, Hunt EA. Team training: implications for emergency and critical care pediatrics. Curr Opin Pediatr. 2008 Jun;20(3):255-60. doi: 10.1097/MOP.0b013e3282ffb3f3.
citation: Issenberg SB, McGaghie WC, Hart IR, Mayer JW, Felner JM, Petrusa ER, Waugh RA, Brown DD, Safford RR, Gessner IH, Gordon DL, Ewy GA. Simulation technology for health care professional skills training and assessment. JAMA. 1999 Sep 1;282(9):861-6. doi: 10.1001/jama.282.9.861.
citation: Donoghue AJ, Durbin DR, Nadel FM, Stryjewski GR, Kost SI, Nadkarni VM. Effect of high-fidelity simulation on Pediatric Advanced Life Support training in pediatric house staff: a randomized trial. Pediatr Emerg Care. 2009 Mar;25(3):139-44. doi: 10.1097/PEC.0b013e31819a7f90.
citation: Nelson KL, Shilkofski NA, Haggerty JA, Saliski M, Hunt EA. The use of cognitive AIDS during simulated pediatric cardiopulmonary arrests. Simul Healthc. 2008 Fall;3(3):138-45. doi: 10.1097/SIH.0b013e31816b1b60.
citation: Rudolph JW, Simon R, Rivard P, Dufresne RL, Raemer DB. Debriefing with good judgment: combining rigorous feedback with genuine inquiry. Anesthesiol Clin. 2007 Jun;25(2):361-76. doi: 10.1016/j.anclin.2007.03.007.
citation: Donoghue A, Nishisaki A, Sutton R, Hales R, Boulet J. Reliability and validity of a scoring instrument for clinical performance during Pediatric Advanced Life Support simulation scenarios. Resuscitation. 2010 Mar;81(3):331-6. doi: 10.1016/j.resuscitation.2009.11.011. Epub 2010 Jan 4.
citation: LeFlore JL, Anderson M. Alternative educational models for interdisciplinary student teams. Simul Healthc. 2009 Fall;4(3):135-42. doi: 10.1097/SIH.0b013e318196f839.
citation: Cheng A, Nadkarni V, Hunt EA, Qayumi K; EXPRESS Investigators. A multifunctional online research portal for facilitation of simulation-based research: a report from the EXPRESS pediatric simulation research collaborative. Simul Healthc. 2011 Aug;6(4):239-43. doi: 10.1097/SIH.0b013e31821d5331.
citation: Issenberg SB, McGaghie WC, Petrusa ER, Lee Gordon D, Scalese RJ. Features and uses of high-fidelity medical simulations that lead to effective learning: a BEME systematic review. Med Teach. 2005 Jan;27(1):10-28. doi: 10.1080/01421590500046924.
citation: Rudolph JW, Simon R, Raemer DB. Which reality matters? Questions on the path to high engagement in healthcare simulation. Simul Healthc. 2007 Fall;2(3):161-3. doi: 10.1097/SIH.0b013e31813d1035. No abstract available.