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Paediatric resident identification of cardiac emergencies

Published online by Cambridge University Press:  22 April 2024

Brittney K. Hills Open the ORCID record for Brittney K. Hills [Opens in a new window] ,
Dana B. Gal Open the ORCID record for Dana B. Gal [Opens in a new window] ,
Matthew Zackoff ,
Brenda Williams ,
Elisa Marcuccio Open the ORCID record for Elisa Marcuccio [Opens in a new window] ,
Melissa Klein  and
Ndidi Unaka
Brittney K. Hills*
Affiliation:
The Heart Institute, Cincinnati Children’s Hospital, Cincinnati, OH, USA
Dana B. Gal
Affiliation:
Division of Pediatric Cardiology, Children’s Hospital of Los Angeles, Los Angeles, CA, USA
Matthew Zackoff
Affiliation:
Division of Critical Care Medicine, Cincinnati Children’s Hospital, Cincinnati, OH, USA Center for Simulation and Research, Cincinnati Children’s Hospital, Cincinnati, OH, USA Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
Brenda Williams
Affiliation:
Center for Simulation and Research, Cincinnati Children’s Hospital, Cincinnati, OH, USA
Elisa Marcuccio
Affiliation:
The Heart Institute, Cincinnati Children’s Hospital, Cincinnati, OH, USA Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
Melissa Klein
Affiliation:
Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA Division of Hospital Medicine, Cincinnati Children’s Hospital, Cincinnati, OH, USA
Ndidi Unaka
Affiliation:
Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA Division of Hospital Medicine, Cincinnati Children’s Hospital, Cincinnati, OH, USA
*
Corresponding author: B. K. Hills; Email: brittney.hills.md@gmail.com
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Abstract

Objectives:

Critical CHD is associated with morbidity and mortality, worsened by delayed diagnosis. Paediatric residents are front-line clinicians, yet identification of congenital CHD remains challenging. Current exposure to cardiology is limited in paediatric resident education. We evaluated the impact of rapid cycle deliberate practice simulation on paediatric residents’ skills, knowledge, and perceived competence to recognise and manage infants with congenital CHD.

Methods:

We conducted a 6-month pilot study. Interns rotating in paediatric cardiology completed a case scenario assessment during weeks 1 and 4 and participated in paired simulations (traditional debrief and rapid cycle deliberate practice) in weeks 2–4. We assessed interns’ skills during the simulation using a checklist of “cannot miss” tasks. In week 4, they completed a retrospective pre-post knowledge-based survey. We analysed the data using summary statistics and mixed effect linear regression.

Results:

A total of 26 interns participated. There was a significant increase in case scenario assessment scores between weeks 1 and 4 (4, interquartile range 3–6 versus 8, interquartile range 6–10; p-value < 0.0001). The percentage of “cannot miss” tasks on the simulation checklist increased from weeks 2 to 3 (73% versus 83%, p-value 0.0263) and from weeks 2–4 (73% versus 92%, p-value 0.0025). The retrospective pre-post survey scores also increased (1.67, interquartile range 1.33–2.17 versus 3.83, interquartile range 3.17–4; p-value < 0.0001).

Conclusion:

Rapid cycle deliberate practice simulations resulted in improved recognition and initiation of treatment of simulated infants with congenital CHD among paediatric interns. Future studies will include full implementation of the curriculum and knowledge retention work.

Keywords

Medical educationpaediatric cardiologysimulation
Type
Original Article
Information
Cardiology in the Young , First View , pp. 1 - 6
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Copyright
© The Author(s), 2024. Published by Cambridge University Press

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