Effects of High-Frequency In Situ Simulation-based Team Training on Clinical Performance During Pediatric Cardiac Arrest

Summary

Cardiac arrest in hospitalized children is a rare occurrence in general and for each healthcare professional in particular, making lack of routine in performing cardiopulmonary resuscitation a challenge. Mortality and morbidity following cardiac arrest depend on the technical (medical knowledge, procedures, etc.) and non-technical (team leadership, communication, etc.) skills performed by the medical team. Simulation-based team training is a well-known and effective method to improve team performance in high-stake and time-sensitive situations, without putting actual patients at risk. Unfortunately, studies show that skills obtained during simulation-based team training decline within a few months. However, recent observational studies have demonstrated improved technical pediatric basic life support skills after short simulation sessions with a high frequency of repeat. The healthcare professionals in these studies are limited to selected groups and tests are performed exclusively on skill stations.

In this study, the effects of a novel high-frequency training program will be investigated. A controlled intervention study in two comparable Danish regions will be conducted. Healthcare professionals in four pediatric departments in the intervention region will participate in the high-frequency training program. Healthcare professionals in four pediatric departments in the control region will continue simulation-based team training with no changes - "as usual" and at a two to three times lower frequency (based on unpublished data). Both groups consist of approximately 600 healthcare professionals, contributing to a total of 1,200 participants included in this project.

Hypotheses: high-frequency training will improve primary outcomes during in-situ simulated pediatric in-hospital cardiac arrest as specified:

1. Teamwork competencies measured by the team emergency assessment measure (TEAM),
2. Time (seconds) to recognition of cardiac arrest.
3. Time (seconds) to initiation of cardiopulmonary resuscitation.
4. Longest chest compression pause duration.

Data collection. To assess clinical performance in both regions unannounced in-situ (in own department with usage of own equipment) simulations of pediatric cardiac arrest will be performed and recorded on video.

Conditions

• Medical Education
• Simulation-based Training
• In-hospital Cardiac Arrest
• Pediatrics
• in Situ Simulation

Interventions

OTHER

High-frequency simulation-based team training

The intervention is a standardized high-frequency training program as described in intervention arm. It is supported by four preliminary initiatives: 1. 15 extra pediatric simulation facilitators were educated, bringing the total number up to 40. 2. A two-day pre-intervention workshop for all pediatric simulation facilitators. 3. A "scenario bank" containing standardized scenarios on common pediatric and neonatal emergencies was created and made accessible for simulation facilitators to support consistency in the intervention. 4. Purchase of equipment. Eight Leardal manikins. Four SimPads. Four monitors. During the intervention year, these will rotate between the pediatric departments.

Sponsors & Collaborators

• Corporate HR, MidtSim, Central Denmark Region

  collaborator UNKNOWN

• University of Aarhus

  lead OTHER

Principal Investigators

• Morten S Lindhard, MD, PhD · Randers Regional Hospital

Study Design

Allocation

NON_RANDOMIZED

Purpose

OTHER

Masking

NONE

Model

PARALLEL

Eligibility

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2023-04-01

Primary Completion

2024-06-30

Completion

2024-06-30

Countries

• Denmark

Study Locations