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Table 1 Program development using Kern’s model of curriculum development

From: Community-based in situ simulation: bringing simulation to the masses

Kern’s stepsStep I/II
Def: critical analysis of health care problems and needs assessment and ideal approach
III. Goals and objectives
IV. Educational content and educational methods
V. ImplementationStep VI
VI. Evaluation and feedback–both learner and program
Norton Children’s KYNeeds assessment at regional transport symposiumGoals and objectives designed by expert review conducted by transport team physicians, nurses, and respiratory therapists
Simulation scenarios: non-accidental trauma, septic shock, congenital heart disease
7 institutions engaged—total of 63 participants from different disciplines/professions
3-h sessions with trained simulation faculty
Spot debriefing—regular commentary throughout each simulation
Leaner reporting positive feedback with curriculum
Endorsed new knowledge acquisition in cognitive, technical, and behavioral skills
Riley Children’s INAcknowledgement of deviation from best practice in neonates transferred to the academic center through morbidity and mortality reviews
Requests from community providers for delivery room education
Needs assessment performed with inter-professional, statewide focus groups
Goals and objectives developed through a multidisciplinary team consisting of neonatal faculty and outreach educators incorporating NRP contentSimulation-based sessions consisting of 30–60 min stations
Debriefing with A&I
Repetition of the simulations after the debriefing
First 2 years: 47 programs and 1300 learners
Ongoing programs, approximately 36–48 community hospitals per year
100% learners reported positive learning experience and acquisition of new cognitive, behavioral, and technical skills
Multi-professional participants reported increased comfort with range of delivery room procedures
Uncovered LSTs involving equipment, medications, resources, personnel, and technical equipment
Ongoing research on clinical outcomes impact from the training and from identifying latent safety threats
COMET-MANeeds assessment based on transfer data to PEDs EDs
Acknowledgement of deviation from best practice in patients transferred to the academic center after calling in expects but not implementing management suggested by pediatric emergency attending
Developed goals and objectives designed by a multidisciplinary group of Peds EM attendings and Peds critical careInitial program
7 participating institutions. Both community EDs and pediatric inpatient units
3 simulations per site
Debrief and question and answer session following each simulation case
76 total participants, all multi-disciplinary, MD, PA, RN, RRT, and MAs, all as per their formal code team
Ongoing program—any community ER, community health center or EMS service
Participants vary by site. Cases are developed to include extended topics including medical cases, trauma and toxicology
Programs able to be tailored to site needs
100% of learners reported positive experience. All desired repeat simulation training and elected every 3 months at their site as the best balance for their practice.
All levels of participants and disciplines reported increased confidence and comfort in running a code, performing lifesaving procedures in the scope of their practice and had increased medical knowledge in the management of critically ill children
Currently given evaluations of system of practice including latent safety threats. Those sites that have repeat visits are being evaluated for change in their system.
Polices are being shared such as dextrose dosing, sepsis guidelines, toxicology information sheets. Etc.
At community sites are implementing code teams and response teams for pediatric emergency readiness
ImPACTS Northeast Regional CollaborativeNeeds assessment based on transfer data to PEDs EDs
Feedback from community hospitals on cases of most concern and stress
Larger collaborative developed goals and objectives designed by a multidisciplinary group of ED nurses, Peds EM attendings, Peds critical care, and anesthesia attendings
Simulation cases: sepsis, hypoglycemic seizure, FB airway, cardiac arrest
> 200 simulations in the northeast regional collaborative sessions involving over 100 physicians, 300 nurses, and 75 technicians
2.5 h sessions per group, all four cases each followed by standard A&I debrief
Standard code team formation per group
Recruitment of educational pediatric champion from the community site to partner with AMC
Evaluation of pediatric acute care
Systems analysis: med errors, equipment issues, safety assessments
Differences in care between high volume and low volume pediatric EDs
Site changes–improved relationships between AMCs and community partners
Changes in equipment/policies—(HI Flo, protocols)