Using simulation to teach paediatric complex care

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Accounts of Chemical Research Pub Date : 2023-10-18 DOI:10.1111/tct.13678

Lucas Bruton, Michael Spewak

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Abstract

Background

Training paediatric residents regarding the care of children with medical complexity (CMC) remains an important challenge given how frequently these patients are treated by trainees and the lack of educational activities specific to these patients. Our goal was to develop and assess a novel simulation regarding the acute care of CMC to improve residents' perceived confidence in areas related to CMC care.

Approach

We developed a case of a patient with multiple chronic medical conditions who presented with acute vital sign changes and worsening discomfort due to an occult femur fracture related to a recent transfer. Paediatric residents worked in teams to complete a full physical exam, create a differential diagnosis, evaluate laboratory and imaging results and create a management plan.

Evaluation

Thirty-three residents out of a total possible sample of 97 (34%) participated in the simulation, which was evaluated using pre- and post-surveys immediately before and after the simulation assessing resident confidence completing tasks related to CMC care. Residents perceived significant improvement in confidence regarding evaluating a differential diagnosis of vital sign and exam changes in CMC (p = 0.023), managing vital sign and exam changes in CMC (p = 0.009) and communicating with team members of CMC (p = 0.049).

Implications

An innovative high-fidelity and low-stakes simulation was effective in teaching trainees about acute management of concerns related to CMC. This simulation may be appropriate for implementation at other institutions, serving as a foundation for use in resident education regarding CMC.

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使用模拟教学儿科综合护理。

背景：鉴于受训人员对这些患者的治疗频率以及缺乏针对这些患者的教育活动，对儿科住院医师进行医疗复杂性儿童护理培训仍然是一项重要挑战。我们的目标是开发和评估一种关于CMC急性护理的新模拟，以提高居民对CMC护理相关领域的感知信心。方法：我们开发了一个患有多种慢性疾病的患者的病例，该患者因最近的转移引起的隐性股骨骨折而出现急性生命体征变化和不适加剧。儿科住院医师团队合作，完成全面体检，制定鉴别诊断，评估实验室和成像结果，并制定管理计划。评估：在总共97个可能的样本中，有33名居民（34%）参与了模拟，在模拟前后使用前后调查进行评估，评估居民完成CMC护理相关任务的信心。居民在评估CMC的生命体征和检查变化的鉴别诊断方面的信心显著提高（p = 0.023），管理CMC的生命体征和检查变化（p = 0.009），并与CMC团队成员沟通（p = 0.049）。含义：创新的高保真度和低风险模拟在向受训人员传授CMC相关问题的急性管理方面是有效的。这种模拟可能适合在其他机构实施，作为CMC住院教育的基础。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.