Table 1 Program development using Kern’s model of curriculum development
From: Community-based in situ simulation: bringing simulation to the masses
Kern’s steps | Step I/II Def: critical analysis of health care problems and needs assessment and ideal approach | Step III/IV Def: III. Goals and objectives IV. Educational content and educational methods | V. Implementation | Step VI Def: VI. Evaluation and feedback–both learner and program |
|---|---|---|---|---|
Norton Children’s KY | Needs assessment at regional transport symposium | Goals 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 IN | Acknowledgement 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 content | Simulation-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-MA | Needs 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 care | Initial 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 Collaborative | Needs 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) |