2024 SAEMF/Simulation Academy Novice Research Grant - $5,000

"High-risk, Low-frequency Pediatric Procedural Training: Simulation-based Pediatric Emergent Airway Curriculum for EM Residents"

Pediatric emergency medicine (PEM) training in emergency medicine (EM) residency programs is diverse in preceptors, critical care exposure, and procedural training. Despite the importance of adequate training in PEM, the exposure to critically ill or injured children requiring emergent management is often limited and sporadic across training sites. In the U.S., the Society of American Emergency Physicians established a Pediatric Education Training Task Force in 1995, seeking to manage the educational experiences of EM residents in the field of PEM. While the Accreditation Council for Graduate Medical Education (ACGME) requires “20% of all emergency department encounters dedicated to the care of pediatric patients” and that “this experience must include the critical care of infants and children,” education and clinical exposure related to pediatric topics varies across residency programs. While there is a growing number of specialized PEM physicians, the majority of pediatric patients are evaluated and managed by non-PEM physicians. It is, therefore, imperative that EM residents be thoroughly trained to not only care for their pediatric patients, but especially in critical procedures such as emergent airway management. Pediatric cardiac arrest is commonly the result of respiratory failure rather than primary cardiac etiology. Therefore, effective pediatric airway management is central to such resuscitative efforts. Advancing from competency to proficiency in such a core resuscitation skill is paramount, albeit challenging. Emergent pediatric airway management is an anxiety-provoking, high-risk event. The low frequency of emergent pediatric intubations in the clinical setting combined with variation in the preceptor's training makes development of competency and proficiency difficult for trainees in the clinical arena. While repetition of procedural skills can help to reinforce techniques, simply performing airway procedures in the clinical setting is insufficient to attain proficiency. To address pediatric gaps in EM training, simulation has been identified as an educational best practice to augment a learner's experience. The purpose of this study is to promote learner's procedural competency and ongoing proficiency through implementation of a pilot simulation-based airway curriculum using multiple learning modalities.