Effects of High-Frequency In Situ Simulation-based Team Training on Clinical Performance During Pediatric Cardiac Arrest
NCT Number: NCT06542861
Status: COMPLETED
Study Type: INTERVENTIONAL
Phases: NA
Conditions: Medical Education|Simulation-based Training|In-hospital Cardiac Arrest|Pediatrics|in Situ Simulation
Interventions: OTHER: High-frequency simulation-based team training
Sponsor: University of Aarhus
Collaborators: Corporate HR, MidtSim, Central Denmark Region
Sex: ALL
Age: CHILD, ADULT, OLDER_ADULT
Enrollment: 1200
Study Design: Allocation: NON_RANDOMIZED|Intervention Model: PARALLEL|Masking: NONE|Primary Purpose: OTHER
Start Date: 2023-04-01
Completion Date: 2024-06-30
Locations: Corporate HR, MidtSim, Aarhus N, Denmark

Summary:
Cardiac arrest in hospitalized children is a rare occurrence in general and for each healthcare professional in particular, making lack of routine in performing cardiopulmonary resuscitation a challenge. Mortality and morbidity following cardiac arrest depend on the technical (medical knowledge, procedures, etc.) and non-technical (team leadership, communication, etc.) skills performed by the medical team. Simulation-based team training is a well-known and effective method to improve team performance in high-stake and time-sensitive situations, without putting actual patients at risk. Unfortunately, studies show that skills obtained during simulation-based team training decline within a few months. However, recent observational studies have demonstrated improved technical pediatric basic life support skills after short simulation sessions with a high frequency of repeat. The healthcare professionals in these studies are limited to selected groups and tests are performed exclusively on skill stations.

In this study, the effects of a novel high-frequency training program will be investigated. A controlled intervention study in two comparable Danish regions will be conducted. Healthcare professionals in four pediatric departments in the intervention region will participate in the high-frequency training program. Healthcare professionals in four pediatric departments in the control region will continue simulation-based team training with no changes - "as usual" and at a two to three times lower frequency (based on unpublished data). Both groups consist of approximately 600 healthcare professionals, contributing to a total of 1,200 participants included in this project.

Hypotheses: high-frequency training will improve primary outcomes during in-situ simulated pediatric in-hospital cardiac arrest as specified:

1. Teamwork competencies measured by the team emergency assessment measure (TEAM),
2. Time (seconds) to recognition of cardiac arrest.
3. Time (seconds) to initiation of cardiopulmonary resuscitation.
4. Longest chest compression pause duration.

Data collection. To assess clinical performance in both regions unannounced in-situ (in own department with usage of own equipment) simulations of pediatric cardiac arrest will be performed and recorded on video.

Primary Outcome Measures: Teamwork competences, Global team score. Assessed in both regions pre- and post-intervention. Assessed according to Team Emergency Assessment Measure (TEAM). Score range from 1-54. 1 being the lowest score and 54 the highest., Up to 36 months|Time to diagnosis of cardiac arrest, Time (seconds) until cardiac arrest is recognized, assessed in both regions by pre- and post-intervention video recordings of unannounced in-situ simulations of pediatric cardiac arrest., Up to 36 months|Time to initiation of cardiopulmonary resuscitation, Time (seconds) until cardiopulmonary resuscitation within standard guidelines for neonates/children is initiated, assessed in both regions by pre- and post-intervention video recordings of unannounced in-situ simulations of pediatric cardiac arrest., Up to 36 months|Longest chest compression pause duration, Chest compression pause durations will be assessed in both regions by pre- and post-intervention video recordings of unannounced in-situ simulations of pediatric cardiac arrest., Up to 36 months
Secondary Outcome Measures: Team effectiveness, Time (seconds) to: call for help, arrival of defibrillator, first rhythm check. Will be assessed in both regions by pre- and post-intervention video recordings of unannounced in-situ simulations of pediatric cardiac arrest., Up to 36 months.|Cardiopulmonary resuscitation quality, Proportion of compressions, and ventilations within guideline recommendations for depth/rate and tidal volumes, respectively., Up to 36 months.