Use of pediatric trauma simulations to facilitate exposure to pediatric trauma resuscitations during training

Impact of a Surgical Skills Curriculum on Medical Student Procedural Experience and Confidence

INTRODUCTION

There is a documented decline in formal procedural skill training in undergraduate medical education. We evaluated a simulation-based skills curriculum before the core surgical clerkship at a large academic institution on its concordance with the skills students perform during the clerkship and its impact on procedural confidence.

METHODS

Between August 2021 and August 2022, students underwent a 2-d simulation-based orientation before the core surgery clerkship. Upon completion of their surgical clerkship, we surveyed medical students on their experience (simulating and/or performing) and confidence in 36 procedural skills considered important by clerkship leadership.

RESULTS

Of 121 eligible medical students, 36 (30%) completed the survey. Median age was 26 y (Q1-Q3 25-26), 69% identified as female, 74% as White, and 17% as Hispanic. There was a significant difference between procedures students simulated before their clerkship and those performed during their clerkship for 16 procedures (P < 0.05). Procedural confidence significantly increased after the skills orientation (P < 0.001), as well as after the duration of the clerkship (P < 0.001). Competence, as measured by skills competition times, did not differ by gender (P > 0.05) and was higher in students bound for surgical residencies (P < 0.001).

CONCLUSIONS

We highlight the value of a skills orientation before the surgery clerkship, as it significantly increases students' procedural confidence. However, we identified a gap between the skills students receive orientation training for and those they are expected to perform on the rotation. Our findings support the need for curricular changes that better prepare students for the surgical clerkship.

Closing the Trauma Performance Improvement Loop With In-situ Simulation

INTRODUCTION

Continuous performance improvement (PI) programs are essential for excellent trauma care. We incorporated PI identified from trauma cases into an in-situ simulation-based medical education curriculum. This is a proof-of-concept study exploring the efficacy of high-fidelity pediatric trauma simulations in improving self-reported provider comfort and knowledge for identified trauma PI issues.

METHODS

This study was performed at an American College of Surgeons-verified Level I Pediatric Trauma Center. Several clinical issues were identified during the trauma PI process, including management of elevated intracranial pressure in traumatic brain injury and the use of massive transfusion protocol. These issues were incorporated into a simulation-based medical education curriculum and high-fidelity in-situ trauma mock codes were held. In-depth debriefing sessions were led by a senior faculty member after the simulations. The study participants completed pre- and postsimulation surveys. Univariate statistics are presented.

RESULTS

Twenty three providers completed surveys for the pediatric trauma simulations. Self-reported provider confidence Likert scale improved from pre- to postsimulation (P = 0.02) and trauma experience and knowledge scores improved from 82% presimulation to 93% postsimulation (P = 0.02).

CONCLUSIONS

High-fidelity pediatric trauma simulations enhance provider comfort, knowledge, and experience in trauma scenarios. By integrating high-fidelity trauma simulations to address clinical issues identified in the trauma PI process, provider education can be reinforced and practiced in a controlled environment to improve trauma care. Future studies evaluating the implementation of clinical pathways and patient outcomes are needed to demonstrate the effectiveness of simulations in PI pathways.

Evaluation of advanced multi-purpose trauma moulage-based training on clinical skills for dealing with trauma-affected individuals in undergraduate nursing students

BACKGROUND

Simulation-based training courses have been developed and widely accepted.The use of simulators can prevent bitter consequences that may sometimes put human lives in danger. Increasing the skill of nursing students in dealing with trauma patients is of great importance. The aim of this study is to evaluate the effectiveness of the simulation-based trauma training program for the management of trauma patients in nursing students.

METHOD

It is an observational approach that focuses on improving the learning of trauma care skills. For this study, 6th and 8th semester nursing students were selected by appropriate sampling method. Previously, these students completed the trauma training course without simulation. Training of trauma skills was done using multi-purpose trauma mollage And we subsequently analyzed the effectiveness of the trauma simulation training program using the OSCE test. In the inferential statistics section, after examining the data distribution (Kolmogrove-Smirnov and Shapiro-Wilk tests), the Wilcoxon test was used to measure significance. SPSS 22 software was used.

RESULTS

The results indicated that the lowest mean score obtained based on a scale of zero to one hundred was for the movement limitation of the injured long bone and the highest was in the skill of oral-nasal intubation and ventilation. The results of the paired t-test showed that clinical skills for dealing with trauma-affected individuals in undergraduate nursingafter simulation training was significantly higher .

CONCLUSION

The implementation of the simulation is accompanied by an increase in the skills of the participants, which leads to the application of the acquired knowledge in real-life scenarios and positive changes. In the learning of the participants, the evaluation of conventional trauma training in Iran, like other countries, shows the need for specialized training through simulation. To ensure the continued effectiveness of simulation-based trauma training courses, it is recommended that administrators and policymakers encourage regular faculty participation in the program. Long term effects of trauma simulators training in nursing student requires further study.

Educational Strategies in Pediatric Trauma Resuscitation Across Disciplines: A Scoping Review

INTRODUCTION

Trauma is the leading cause of death and disability in children. Differences in mechanism, injury pattern, severity, and physiology in this population distinguish pediatric trauma patients from adults. Educational techniques including simulation and didactics may improve pediatric readiness in this setting. We summarize the literature across disciplines, highlighting the curricular approaches, target provider population, educational content, content delivery method, and Kirkpatrick level for pediatric trauma resuscitation education.

METHODS

The MEDLINE (via Ovid), Embase (via Elsevier), Cumulative Index to Nursing & Allied Health Literature Complete (via EBSCO), Education Database (via ProQuest), and Web of Science Social Science Citation Index and Science Citation Index (via Clarivate) were searched. We reviewed 90 manuscripts describing pediatric trauma resuscitation education programs. When available, target provider population, curricular content, delivery method, and Kirkpatrick level were obtained.

RESULTS

Nurses (50%), residents (45%), and attending physicians (43%) were the most common participants. Airway management (25%), shock (25%), and general trauma (25%) were the most frequently taught concepts, and delivery of content was more frequently via simulation (65%) or didactics (52%). Most studies (39%) were Kirkpatrick Level 1.

CONCLUSIONS

This review suggests that diverse strategies exist to promote pediatric readiness. Most training programs are interdisciplinary and use a variety of educational techniques. However, studies infrequently report examining the impact of educational interventions on patient-centered outcomes and lack detail in describing their curriculum. Future educational efforts would benefit from heightened attention to such outcome measures and a rigorous description of their curricula to allow for reproducibility.