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Background: In 2010, Pediatric Hospital Medicine (PHM) core competencies were published. In response, our hospital medicine section and simulation program assessed and implemented simulation-based training to improve competency.
Objective: Our primary aims were to 1) determine specific knowledge, skill and competency needs in alignment with pediatric hospitalist scope of practice, then use results to design a simulation-based curriculum and 2) implement and evaluate the impact of this curriculum. Secondary aims included describing feasibility and learner satisfaction regarding simulation as a faculty development tool.
Design/Methods: Baseline and post-training surveys were administered to 49 physicians, providing self-ratings from Novice to Expert on published PHM competencies. We averaged participant responses on individual questions into specific domain scores, bundled according to learning content needs. Six targeted simulation sessions were developed, piloted and implemented. Hospitalist faculty participated in simulation at regular intervals over the study period. The change for each domain was assessed with a Sign-Rank test. Each participant was deemed competent in a domain if their mean score was three or greater. The change in competency status was determined using McNemar’s test. We determined if the change in score for each domain was different across years of experience or the number of sessions attended using Kruskal–Wallis tests.
Results: Baseline survey response rate was 98% with 85% completing the post-training assessment. The median number of years of experience as an attending was 4 [IQR: 1-9].
Areas with the lowest self-reported competency on the baseline assessment included medically complex care, code cart, vascular access & emergency medications, advanced airway management, and team communication. Post curriculum scores improved significantly for 5 of 9 domains and percent competent in one domain. Mean scores increased to three or greater in all domains reaching the designated self-assessment competency threshold. Change in scores was not associated with years of experience or increased session attendance. Overall, participants rated the educational sessions “good” or “excellent” at a rate of 98%.
Conclusions: Results from a baseline assessment were instrumental in designing a simulation-based faculty education curriculum. Post-training analysis revealed gains in multiple domains and identified future opportunities for targeted intervention to address persistent competency gaps. Hospitalists reported participation in simulation sessions positively impacted patient care and team communication. As new subspecialists, pediatric hospitalists across the country may find value in a similar process to provide novel faculty education.
Carney, Lisa; Hall, Matt; Heller, Kayla R.; and Kennedy, Chris, "Development, Implementation, And Evaluation Of A Simulation Based Educational Curriculum Targeted For Pediatric Hospitalists" (2022). Research at Children's Mercy Month 2022. 27.