The International Network for Simulation-based Pediatric Innovation, Research, and Education would like to present our research, grant funding, and publication information within the network.

1. INSPIRE Network Report
2014-2015

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INSPIRE
INSPIRE
INSPIRE
International Network for Simulation-based Pediatric Innovation, Research and Education
INSPIRE NETWORK REPORT
2014-2015
Mission & Vision
Mission: To improve the delivery of medical care to acutely ill
children and ultimately improve survival from acute illness in
the pediatric population.
Vision: To bring together all individuals working in pediatric
simulation-based research to shape and mold the future of
pediatric simulation research by answering important
questions pertaining to resuscitation, technical skills,
behavioral skills, debriefing and simulation-based education.
History
The INSPIRE Network is the International Network for Simulation-based Pediatric Innovation, Research,
and Education. INSPIRE was formed in 2011 from a large group of pediatric simulation-based researchers
from a variety of disciplines and specialties looking to improve collaboration, mentorship, and
productivity. We merged two large-scale existing pediatric simulation research networks, EXPRESS and
POISE, into INSPIRE in 2011.
Organizational Structure
This process has brought down the walls between institutions through shared resources and a mutual
understanding of each other’s work towards a common goal. Our work has helped synergize ongoing
projects in overlapping domains. We are not a formal academic society; rather, we are a bottom-up,
grassroots organization that has formed to meet the needs of the rapidly changing landscape of pediatric
simulation research. The network has been extremely productive in advancing and guiding simulation-
based research activities. We provide a structure and process of mentorship to junior investigators.
Resources to our members include an online database of ongoing studies and investigators, access to a
research coordinator, librarian and statistician, online data sharing infrastructure (video, survey, database
management) and a manuscript oversight committee for pre-publication review.
INSPIRE is led by a diverse and inter-professional executive committee from institutions across the globe:
Co-chairs
Adam Cheng MD, Alberta Children’s Hospital, Canada
Marc Auerbach MD, MSc, Yale University, USA
Research chair
David Kessler MD, MSc, Columbia University, USA
International chair
Ralph Mackinnon MD, Royal Manchester Children’s Hospital, UK
Technology chairs
Todd Chang MD, Children’s Hospital of LA, USA
Jordan Duval-Arnould, Johns Hopkins University, USA

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INSPIRE
INSPIRE
INSPIRE
International Network for Simulation-based Pediatric Innovation, Research and Education
INSPIRE NETWORK REPORT
2014-2015
Manuscript Oversight Committee chair
Vinay Nadkarni MD, Children’s Hospital of Philadelphia, USA
Senior co-chairs
Elizabeth Hunt MD, PhD, Johns Hopkins University, USA
Martin Pusic MD, PhD, New York University School of Medicine, USA
INSPIRE Network Membership
Members 580
Sites 214
Countries 31
Research Process and Network Support Structure
Investigators are encouraged to begin their work by (1) submitting an ALERT presentation that is a brief
description of their idea. Next, (2) the investigator is paired with a mentor and provided the “lay of the
land” of ongoing research in that area to promote collaboration across projects. The investigator then
conducts a (3) systematic review of the literature and plans an initial pilot study. The (4) pilot study
methods are reviewed by the INSPIRE executive and shared with the network to recruit collaborators for
a subsequent collaborative study. (5) The executive helps to facilitate multicenter studies with IRB
templates, scope of work templates, data use agreements, collaborative oversight and clear expectations
from the start. INSPIRE can also provide specialty consultation with leading experts in biostatistics,
educational research, technology and psychometrics. When the team has completed their work, (6) the
manuscript oversight committee provides a pre-review of the work product and guidance on submission
for publication. Additionally, (7) for selected projects the executive helps to provide letters of support for
grant submission. In exchange for this support the INSPIRE investigator provides acknowledgement of
INSPIRE in any presentation/publication and support for the INSPIRE administration on grants. See Figure
for details.

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INSPIRE
INSPIRE
International Network for Simulation-based Pediatric Innovation, Research and Education
INSPIRE NETWORK REPORT
2014-2015
Figure: INSPIRE Research Process and Network Support Structure
Young
Investigator
with Research
Idea
•Online Research Series
•Senior INSPIRE mentor (via online mentor match) to help with establishing research goals and development of 1 page
“specific aims” page
Systematic
Review or
Needs
Assessment
•INSPIRE Research Coordinator to assist with methodology for systematic review
•INSPIRE Librarian to assist with literature search
Pilot Study
•Review and revise study protocol with INSPIRE mentor
•Review study protocol with INSPIRE technology director to discuss possible tech-assisted outcome measures
•Review with INSPIRE statistical consultant to solidify analysis plan, feasibility, and power analysis
Multicenter
Study
•INSPIRE scientific committee to review protocol and grant proposal
•INSPIRE website to assist in finding collaborators and recruitment sites
•INSPIRE research portal for data collection
•Data analysis and submission to Manuscript Oversight Committee (MOC)
Knowledge
Translation
•INSPIRE research assistant and graphic designer to assist with poster preparation
•INSPIRE writing group and scientific committee to assist with review of manuscripts and mitigation of authorship issues
and byline
•Submission of manuscript for peer review, amend with mentor and writing group, publish

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INSPIRE
INSPIRE
International Network for Simulation-based Pediatric Innovation, Research and Education
INSPIRE NETWORK REPORT
2014-2015
INSPIRE Research Themes
INSPIRE has conducted a series of consensus conferences to identify themes of inquiry within pediatric
simulation (Tables). This framework will guide our networks focus over the next five years.
Training and Assessment
Debriefing Develop/assess/implement effective techniques for debriefing real/sim events
IPE, Teamwork,
Communication
Develop/assess/implement effective techniques for team training
Procedural,
Psychomotor Skills
Develop/assess/implement effective techniques for skills development retention
Innovation and Technology
Technology
Develop/assess/implement novel technologies to improve processes of care and
pediatric outcomes
Acute Care and
Resuscitation
Develop/assess/implement novel techniques for improving care of pediatric
patients
Human Factors Assess the roles of human factors when providing care to pediatric patients
Patient Safety
Explore the key variables that influence patient safety and assess strategies to
mitigate

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INSPIRE
International Network for Simulation-based Pediatric Innovation, Research and Education
INSPIRE NETWORK REPORT
2014-2015
New INSPIRE Projects Presented in 2015
Project
Lead
Investigator
Lead
Institution
Description Current Status
The use of Leaderboards &
Competition to improve
self-initiated CPR training
T. Chang Children’s
Hospital Los
Angeles
International, multi-institutional
randomized control-crossover
study examining the effect of a
competitive leaderboard on usage
frequency and performance on
simulated CPR skills.
Have funding
from AHA for 2
years. In IRB &
Recruitment
phase as of
July 2015.
Resuscitating Teamwork and
Safety Using
Acute Event Debriefing
M. Moga Ann &
Robert H.
Lurie
Children’s
Hospital of
Chicago
Nurse-led, acute event debriefing
for patients suffering cardiac arrest
in the ICU.
In development.
The effect of summative
feedback on the accuracy of
provider perceptions and
the quality of CPR during a
simulated pediatric cardiac
arrest
L. Brown University/
Hasbro
Children’s
Hospital
CPR certified healthcare providers;
1) summative feedback re: quality
of CPR; 2) HCP with no summative
feedback. Test improved quality of
CPR and improved accuracy of HCP
perceptions.
In development.
The use of Leaderboards &
Competition to improve
High School CPR training
R. MacKinnon Royal
Manchester
Children’s
Hospital
Examining the effect of a
competitive leaderboard on usage
frequency and performance on
simulated CPR skills in highschools.
Recruiting sites.
Integrating Cognitive Aids
(INCA)
D. Bould Children’s
Hospital of
Eastern
Ontario,
University of
Ottawa
Use of knowledge-based cognitive
aids in interprofessional teams.
PSI funding
received.
Pediatric Simulation in Rural
India: PedSRI Study
S.
Thyagarajan
PediSTARS
India
Develop a structured Simulation
training program to address
recognition, stabilization and
transfer to a higher centre & study
the impact on patient outcomes.
In development.
NRP eSimulation A. Ades Children’s
Hospital of
Philadelphia
Comparison of eSim to video
review to no training after initial
NRP course for enhancing
retention at 6 months.
Finalizing study
population &
intervention
arm.
Measurement of Stress
Levels in Simulation and the
Impact of Stress on
Performance: Announced
Versus Unannounced
Simulation Based Training
S. Lyons Bristol
Medical
Simulation
Centre
Measuring Impacts of stress on
performance, and physiological and
biochemical changes associated
with the stress response using
announced versus unannounced
simulation based training.
In development.

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International Network for Simulation-based Pediatric Innovation, Research and Education
INSPIRE NETWORK REPORT
2014-2015
Development of a Pediatric
Simulation Curriculum and
Database Collaborative
T. Stavroudis Children’s
Hospital Los
Angeles
To form a pediatric simulation
curriculum collaborative to
establish a core group of educators
and simulationists to build a
credentialed, centralized pediatric
simulation scenario platform and
database that utilizes the ABP
Board Content Specifications and
ACGME Core Competencies and
Developmental Milestones as the
core principles of the curriculum.
Establishing
infrastructure
and identifying
grant sources.
Script Assisted Feedback to
Educate (SAFE Tool)
E. Sigalet Sidra
Research
and Medical
Center
Testing the SAFE tool to support
debriefers in using a structured
approach with all forms of
feedback to optimize learning.
Research design
in development.
Improving the quality of
team training and
performance during
interprofessional in situ
mock code blue simulations:
A randomized controlled
mixed-methods study
C. Walsh Hospital for
Sick Children
Comparing just in time training to
no training for interprofessional
teams in mock in-situ code blue
simulations.
IRB Complete.
Funded. Starting
recruitment
phase.
INSPIRE Projects Presented In 2014 (Ongoing / Completed)
Project
Lead
Investigator
Lead
Institution
Description Current Status
Improving Basic Life Support
and Outcomes from Cardiac
Arrest: Implementation and
Evaluation of the American
Heart Association’s
Resuscitation Quality
Indicator (RQI) CPR Training
Program
A. Cheng Alberta
Children’s
Hospital
The objective of this study is to
evaluate the effectiveness of the
AHA’s RQI program when
compared with traditional annual
BLS recertification (for pediatric
healthcare providers).
Ethics received.
Starting
recruitment.
Development of simulation-
based assessment tools for
the general pediatrics
milestones
L. Mallory Maine
Medical
Center
Will use a modified Delphi method
with group of pediatric simulation
experts and program directors to
identify priority areas for
simulation-based assessment
aligned with the ACGME Next
Accreditation System Pediatric
Specialty Milestones.
Survey phase
complete.
Developing
assessment
tools in 3
prioritized
areas.
Manuscript
preparation.
Use of Simulation in Limited
Resource Countries. How
can it be done?
D. Moro-
Sutherland
Texas
Children’s
Hospital
Two projects have come out of the
original presentation during the
INSPIRE meeting at IMSH 2014.
1. Low cost sim
repository
housed b/w

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INSPIRE
International Network for Simulation-based Pediatric Innovation, Research and Education
INSPIRE NETWORK REPORT
2014-2015
1. Education through low-cost
simulation in the global health
arena
2. Use of Simulation in Limited
Resource Countries: How can it be
done?
Open Pediatrics
& IPSS.
2. Low cost sim
cases written.
Pilot in Feb
2016.
Incorporate sim
into curriculum
by summer
2016.
Handheld High Fidelity
Simulation Training For IV
Catheterization
D. Weiner
M.
Ottensmeyer
Boston
Children’s
Hospital/Har
vard Medical
School
Build/use handheld high fidelity
haptic simulation training device to
teach PIV catheterization
anywhere, anytime independent of
infrastructure. Plan to compare to
traditional methods of learning i.e.
IV arm, instructor.
INSPIRE
multicenter
study in
planning stage.
The effect of random leader
role assignment on task and
team performance during
CPR
S. Ambati Cohen
Children’s
Medical
Center of
NY, NSLIJ
The main aim of this project is to
show pre-designated leader role
will improve team performance
and to see whether physician or
the nurse in the leader role will
make a difference. Intervention-
groups that has pre-designated
leader role. Control – No leader
role.
Recruitment in
progress.
A Virtual Pediatric Simulator
(VPS) For Emergency
Scenario Training of Military
Medical Personnel
J. Gerard
A. Scalzo
Saint Louis
University
Project funded by the ONR to
develop a game-based virtual
reality simulator for training on
high-stakes pediatric emergency
medicine scenarios.
Scenarios in
development.
User testing and
validation study
in summer
2015.
Resuscitation Review to
Guide Educational
Interventions
A. Ruscica
D. Kessler
Morgan
Stanley
Children’s
Hospital,
Columbia
University,
New York
Pediatric Emergency medicine
practitioners will identify a variety
of key points learned or reviewed
during resuscitations they have
been involved in. These key points
identified during resuscitations will
be areas that the rest of the
pediatric emergency staff would
like more education on and identify
as low self-efficacy topics.
Final phase of
data collection.
Improving realism of PALS-
courses with smart
simulation tools & children
W. Burkhard
et al
PSRCS
Pediatric
Simulation
Research
Collab.
Southtyrol
Currently only use BLS and ALS
mannequins during PALS courses.
Introduce tablet patient monitors
an all PALS stations. Use of real
sound sequences on 2 of 3 practical
stations comparing learning
Research
protocol in
development.

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INSPIRE
International Network for Simulation-based Pediatric Innovation, Research and Education
INSPIRE NETWORK REPORT
2014-2015
outcomes of students in differently
equipped teaching stations.
Integration of real children. Change
of skin color.
Simulation using the
PECARN Head Trauma Rule
to Reduce CT Imaging
K. Ching New York
Presbyterian
Hospital -
Weill Cornell
Medical
Center,
Mount Sinai
Hospital
Limiting unnecessary CT scans for
children with head trauma.
PECARN clinical prediction rule
helps identify children with very
low risk for TBI( Traumatic Brain
Injury). Objective of this trial is to
develop a pediatric simulation
exercise illustrating the use of the
PECARN clinical prediction rule.
Second year of
pilot study is
complete. Now
enrolling
subjects for
multi-center
prospective
randomized
control
educational
intervention
study involving
6 sites.
INSPIRE Projects Presented In 2013 (Ongoing / Completed)
Project
Lead
Investigator
Lead
Institution
Description
Current Status
of the Project
Learning Retention and the
Timing of Refresher
Education After the
Deliberate Practice of
Radiograph Interpretation
Martin Pusic
Kathy
Boutis
New york
University,
University of
Toronto
Deliberate practice on cognitive
simulators produces reliable
individualized learning. Rates of
retention and need for refreshers is
difficult to predict. This RCT uses
the learning of radiograph
interpretation to develop a
framework for “forgetting curves”.
Phase 1
completed;
recruitment
underway for
Phase 2.
Exploring the Facilitators and
Barriers to Implementing
Simulation-based
Competency Assessments to
Determine Trainees'
Readiness for the Infant
Lumbar Puncture (LP)
Procedure
Julie
Pasternack
Ryan
McBeth
Rita Dadiz
University of
Rochester
To determine the factors that
increase or decrease the likelihood
that sites participating in the
lumbar puncture study would
achieve greater compliance with
their interns performing
competency assessments prior to
their first LP.
In Manuscript
preparation.
Rapid Cycle Deliberate
Practice for Resuscitation
Teams
Daniel
Lemke Cara
Doughty
Texas
Children’s
Hospital
Fast-paced deliberate practice
model to train residents in
resuscitation management over
short, but frequent exercises. It also
aims at comparing the traditional
and RCDP techniques.
Published RCDP
curriculum for
residents. In
Manuscript
preparation.

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INSPIRE
International Network for Simulation-based Pediatric Innovation, Research and Education
INSPIRE NETWORK REPORT
2014-2015
Simulation to teach
management of
tracheostomy emergencies
for new parents
Jennifer
Arnold
Shilpa
Hundalani
Texas
Children’s
Hospital
PepTALC is a simulation-based
training initiative to teach primary
caregivers of infants being
discharged from the NICU with
tracheostomies and ventilators on
how to manage airway
emergencies. Developed a 4 hour
training module that has been well
received by families.
Next steps are
to develop a
multi-centered
trial that can
hopefully
establish
changes in
actual patient
care outcomes.
Randomized Trial of
Continuous Capnography
during Simulated Arrests
David
Kessler
Columbia
University
This study attempts to ascertain
benefits to resuscitation
management & potential patient
outcomes with the addition of
capnography monitoring.
Pending grant
re-submission.
Improving Code Team
Performance and Survival
Outcomes: Implementation
of Pediatric Composite
Resuscitation Training
Knight L,
Gabhart J.
Lucile
Packard
Children’s
Hospital
Stanford
This research examined the
implementation of a composite
resuscitation pediatric team
training program that incorporated
AHA PALS training, ongoing training
of emergency equipment, code
roles, institution specific code roles
and responsibilities and in-situ
unannounced mock codes to all
interprofessional members of the
pediatric Code team throughout
the institution in which our
pediatric team responded with the
hypothesis that this training would
improve code team performance
and survival outcomes
Ongoing &
supported
within
organization.
Broadened to
include; 1)Unit-
based resus
training; 2)
Unannounced
in-situ mock
codes held twice
monthly
Development of a
Standardized Process for
INSPIRE Procedure Kits
Marjorie
White
Taylor
Sawyer
Alabama
Children’s
Hospital,
Seattle
Children’s
Hospital
This is a secondary study that has
become its own larger entity. It
initially derived from the work of
Dr. Kessler & Dr. Auerbach in their
infant Lumbar Puncture procedure
teaching kit, with validated
checklists and training videos and
methodologies. Now, Dr. White &
Dr. Sawyer want to use the same
validation processes to develop
assessment & teaching kits for all
procedures in pediatrics.
Manuscript
accepted for
publication in
Academic
Medicine.
Continued
development of
validated
checklists to be
included into
procedure kits.
Comparison of Endotracheal
Intubation + Umbilical venous
Catheter vs. Laryngeal Mask
Airway + Intraosseous Needle
in NRP
Byrne B,
Wetzel E.
Indiana
University
Study new NRP trainees in sim
environment. Measured time and
success to place an endotracheal
tube and an UVC compared to
placing an LMA and IO in a critically
ill newborn in the delivery room.
Project
Complete.
Manuscript is in
progress.

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INSPIRE
International Network for Simulation-based Pediatric Innovation, Research and Education
INSPIRE NETWORK REPORT
2014-2015
Trauma Outreach Project Chris
Kennedy
Ralph
Mackinnon
University of
Manchester,
Children’s
Mercy
Hospital
The INSPIRE Pediatric Trauma
Outreach project spans 3
continents and 5 countries, and
aims to standardize and improve
pediatric major trauma care.
Recruitment in
progress.
Pediatric Simulation and the
Milestones
Smith A. Develop cases around the ACGME
Pediatrics Milestones. Correlate the
evaluations of the sim cases with
clinical evaluations and inservice
exams.
Temporarily on
hold.
Reorganizing
team.
INSPIRE Projects Presented In 2012 (Ongoing / Completed)
Project Lead
Investigator
Lead
Institution
Description Current Status
Use of Epinephrine
Auto injectors in the
management of
Anaphylaxis
DJ Scherzer
Elizabeth
Hunt
Mindy
Hamilton
Nationwide
Children’s,
Johns
Hopkins
University,
Children’s
Pittsburgh
Anaphylaxis is a potentially life
threatening allergic reaction.
Studies have shown that early
identification and treatment
improves outcome. However,
anecdotal experience reveals
prolonged time to
administration of
subcutaneous epinephrine and
potentially life threatening
errors in administration. This
study is aimed at exploring
whether the use of auto
injectors will decrease the time
to administration and decrease
dosing errors for epinephrine.
Poster presentation at
IPSSW 2015. Manuscript
preparation in progress.
ImPACTS: Improving
Pediatric Acute Care
Through Simulation
Marc
Auerbach
Yale
University
ImPACTS is Improving
Pediatric Acute Care through
Simulation and is designed to
assess and improve care for
pediatric resuscitation in
general Emergency
Departments across the
Northeast U.S.
Published 2 manuscripts,
multiple other
manuscripts in progress.
Handoff Assessment Shilpa
Hundalani
Texas
Children’s
Hospital
Utilizing simulated experiences
the research team will develop
a training curriculum, including
a validated hand-off score tool
that will teach pediatric
residents how to consistently
perform a standardized patient
hand-off during a critical
patient event.
In progress.

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INSPIRE
INSPIRE
International Network for Simulation-based Pediatric Innovation, Research and Education
INSPIRE NETWORK REPORT
2014-2015
Neonatal intubation
group
Lindsay
Johnston
Yale
University
Neonatal intubation is a
procedure performed in other
to secure the airways of a child
to assist in ventilation. This is
usually performed through the
mouth in neonates. This
project attempts to design
various educational
interventions aimed at
improving competence in
neonatal intubation.
Completed literature &
Delphi review. Draft
checklist
finalized. Working to
assess validity evidence
& reliability for checklist
when used in simulated
environment. Manuscript
preparation in Fall 2015.
Lumbar Puncture David Kessler Columbia
University
Lumbar Puncture is used in the
assessment of the febrile child
in the assessment of Central
Nervous System infection. This
study has designed an
educational intervention and is
currently assessing the impact
of this intervention on
competency in performing a
lumbar puncture among
interns. This project seeks to
improve outcomes with infant
LP procedure through INSPIRE
skills training package.
Complete. Working on
manuscripts and grants
for future work.
Script Concordance
Testing in infant
lumbar puncture
Todd Chang Children’s
Hospital of
LA
The decision to perform an
infant lumbar puncture is often
wrought with controversy
given the nature of the
procedure and the parental
anxiety. Script concordance
Testing is a method of
assessing clinical decision
making skills in situations of
uncertainty. This study aims to
define the most and least
controversial scenarios
involving infant LP according to
attending physicians in a
variety of pediatric fields.
Recruitment complete.
Manuscript 1 published
in Academic Medicine.
Manuscript 2 accepted in
Pediatric Emergency
Care.

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International Network for Simulation-based Pediatric Innovation, Research and Education
INSPIRE NETWORK REPORT
2014-2015
Research Project Funding for INSPIRE Network Members from 2014-2015
Year Project and Funding Agency
2016-2021 Simulation-based Pediatric Research Collaborative (SPARC) Network for Trauma
With: Dr. Vinay Nadkarni, Dr. Nancy Kassam-Adams, Children’s Hospital of Philadelphia
*Applied for Funding to: National Institutes of Health, Child Health and Development Branch
$3,750,000 USD
2015-2018 Consolidating tools for outcomes in resuscitation (CONTOUR)
With: Dr. Dylan Bould (PI), Dr. Sylvain Boet (University of Ottawa), Dr. Farhan Bhanjji, Dr. Adam Cheng, Dr.
Marc Auerbach, Dr. Linda Brown
Funded By: Physicians’ Services Incorporated Foundation, $248,500 CAD
2015-2017 The Effect of a New Training Program on CPR Quality of Paediatric Healthcare Providers: A Randomized
Trial with Economic Evaluation
With: Dr. Adam Cheng (PI), Alberta Children’s Hospital and University of Calgary
Funded By: The Royal College of Physicians and Surgeons of Canada, Medical Education on Research Grant
$50,000 CAD
2015-2017 Teaching and Assessing Cost- and Time-effective Patient Care using Serious Gaming Strategies
With: Dr. Todd Chang (PI), Children’s Hospital Los Angeles
Funded by: Stemmler Fund, National Resident Matching Program
$150,000 USD
2015-2017 Using leaderboards to improve CPR simulation practice among healthcare professionals
With: Dr. Todd Chang (PI), Children’s Hospital Los Angeles
Funded by: American Heart Association Western States Affiliates Grant-in-Aid
$140,000 USD
2015-2017 Leaderboards for Improving CPR Training in Schools
With: Dr. Ralph MacKinnon, Royal Manchester Children’s Hospital
Funded By: Health England Research Grant
$100,000 USD
2015-2016 Optimizing Integration of CPR Feedback Technology with CPR Coaching for Cardiac Arrest
With: Dr. Adam Cheng (PI), Alberta Children’s Hospital and University of Calgary
Funded By: Heart and Stroke Foundation of Alberta Seed Grant
$45,000 CAD
2015-2016 Improving CPR Quality of Pediatric Healthcare Providers with Longitudinal Training and Real-Time CPR
Feedback: A Randomized Trial with Economic Evaluation
With: Dr. Adam Cheng (PI), Alberta Children’s Hospital and University of Calgary
Funded By: Department of Pediatrics Innovation Grant
$24,932 CAD
2015-2016 Pilot Evaluation of a Novel CPR Feedback Device in PICU: Can We Improve the Quality of CPR we Deliver to
Patients?
With: Dr. Adam Cheng (PI), Alberta Children’s Hospital and University of Calgary
Funded By: Department of Pediatrics Innovation Grant
$23,020 CAD
2015-2016 INSPIRE Network Training for Pediatric Emergency Care
With: Dr. David Kessler (PI), Columbia University College of Physicians & Surgeons
Funded by: RBaby Foundation
$55,318 USD

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INSPIRE
International Network for Simulation-based Pediatric Innovation, Research and Education
INSPIRE NETWORK REPORT
2014-2015
2014-2018 Assessing Simulation in Pediatrics: Improving Resuscitation Events: KidSIM-ASPIRE Simulation Research
Program Infrastructure Grant
With: Dr. Adam Cheng (PI), Alberta Children’s Hospital and Dr. Vincent Grant, University of Calgary
Funded by: Alberta Children’s Hospital Research Institute, Alberta Children’s Hospital Foundation and
Department of Pediatrics Research Grant
$150,000
2014-2015 Improving CPR Quality and Cost Effectiveness with the American Heart Association’s Resuscitation Quality
Improvement Program
With: Dr. Jeffrey Lin (PI, PhD Candidate), Dr. Tyrone Donnon, Dr. Gillian Currie, University of Calgary, Dr.
Vinay Nadkarni, Children’s Hospital of Philadelphia, Dr. Adam Cheng, Alberta Children’s Hospital
Funded by: Laerdal Foundation for Acute Medicine
$25,000 USD
2014-2015 ImPACTS: Improving Pediatric Acute Care Through Simulation
With: Dr. Marc Auerbach (PI), Yale University. Site PIs include: Dr. Vinay Nadkarni (CHOP), Katz-Nelson
(Hopkins), Mindy Fedlor-Hamilton (Pitt), Dr. David Kessler (Columbia), Dr. Linda Brown (Hasbro), Dr. Walsh
(Umass), Dr. Gangadharan (Cohen’s/Hofstra)
Funded by: RBaby Foundation
$150,000 USD
2014-2015 Trauma Team and Leadership Simulation
With: Dr. Todd Chang (Co-I), Children's Hospital Los Angeles
Funded by: Children's Hospital Los Angeles Barbara Korsch Educational Grant
$10,000 USD
2014 A fitness for purpose study of the Field Assessment Conditioning Tool (FACT development & outreach pilot
study)
With: Dr. Ralph MacKinnon, Chris Kennedy, Rachael Fleming, Catherine Doherty, Lambert Schuwirth &
Terese Stenfors-Hayes, Royal Manchester Children’s Hospital
$,10,000 (UK)
2014 A fitness for purpose study of the Field Assessment Conditioning Tool in NZ (FACT development & outreach
pilot study)
With: Dr. Ralph MacKinnon ,Dr Mike Shepherd, Dr Jo Cole, and Dr Chris Kennedy, Royal Manchester
Children’s Hospital
$10,000 (NZ)
2013-2015 A Virtual Pediatric Simulator (VPS) for Emergency Scenario Training of Military Medical Personnel
With: Dr. James Gerard (PI), Anthony Scalzo (Co-PI)
$541,807.00 USD
2013-2014 Procedural Skills Training in Pediatric Residency
With: Dr. Zia Bismilla, Hospital for Sick Children, Feldman M, Amin H, Dubrowski A.
Funded by: Hospital for Sick Children Paediatric Consultants Education Research Grant
$4,085 CAD
2013-2014 Maximizing Summative and Formative Assessment in Simulation-Based Settings
With: Dr. Adam Cheng (Co-I), Alberta Children’s Hospital and University of Calgary
Funded By: The Royal College of Physicians and Surgeons of Canada Medical Education Research Grant
$24,340 CAD
2013-2014 Validation study for simulating capillary refill in a mass-casualty simulation
With: Dr. Todd Chang (PI), Children's Hospital Los Angeles
Funded by: Southern California Clinical Translational Science Institute Research Pilot Fund
$26,400 USD

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2013-2014 INSPIRE Network Infant Lumbar Puncture Competency Assessment
With: Dr. Todd Chang (Sub-Contractor), Children's Hospital Los Angeles
Funded by: RBaby Foundation
$14,000 USD
2013-2014 ImPACTS: Improving Pediatric Acute Care Through Simulation
With: Dr. Marc Auerbach (PI), Yale University
Funded by: RBaby Foundation
$300,000 USD
Site PIs include: Dr. Vinay Nadkarni (CHOP), Katz-Nelson (Hopkins), Mindy Fedlor-Hamilton (Pitt), Dr. David
Kessler (Columbia), Dr. Linda Brown (Hasbro), Dr. Walsh (Umass), Dr. Gangadharan (Cohen’s/Hofstra)
2012-2015 Advancing and Optimizing Quality of Resuscitation in Children with Cardiac Arrest
With: Dr. Elizabeth A. Hunt (PI), Johns Hopkins University
Funded by: The Hartwell Foundation
$300,000 USD
2012-2014 CPR Training Using High-Fidelity Simulation and Train to Perfection in Medical Students
With: Dr. Jonathan Duff (PI), University of Alberta, Dr. Carol Hodgson, University of Alberta, Dr. Farhan
Bhanji, McGIll University, Dr. Adam Cheng, Alberta Children’s Hospital
Funded by: Teaching and Learning Enhancement Fund, University of Alberta
$18, 379 CAD
Abstracts (Poster, Oral), Workshops, Presentations
1. Auerbach M, Kessler DO, Patterson MD. The Use of In-Situ Simulation to Detect Latent Safety
Threats in Pediatrics: A Cross-Sectional Survey. BMJ STEL In Press 2015
2. Braga MS, Tyler MD, Rhoads JM, Cacchio MP, Auerbach M, Nishisaki A, Larson RJ. The Effect of
Just-in-Time Simulation Training on Provider Performance and Patient Outcomes for Clinical
Procedures: A Systematic Review. BMJ STEL In Press 2015
3. Doughty C, Lemke D. Rapid Cycle Deliberate Practice Round Table Discussion. International
Pediatric Simulation Society Symposia and Workshops, Vancouver, BC, May 2015.
4. McLaren S, Harwayne-Gidansky I, Critelli K, Garnett J, Ching K. Effectiveness of High Fidelity
Simulation on Clinical Application of the PECARN Head Trauma Rule.Poster, Pediatric Academic
Society (PAS) San Diego, CA 2015.
5. McLaren S, Harwayne-Gidansky I, Critelli K, Garnett J, Ching K. Effectiveness of High Fidelity
Simulation on Clinical Application of the PECARN Head Trauma Rule.
Platform: Eastern Society for Pediatric Research (ESPR) Philadelphia,
PA 2015.
6. Harwayne-Gidansky, I., Ching, K., & Critelli, K. High-Fidelity
Simulation Improves Resident Learning For The Pecarn Head Trauma
Rule. Poster: Society for Critical Care Medicine Congress (SCCM)
Phoenix, AZ 2015.
7. Duff, Bhanji, Lin, Overly, Brown, Charnovich, Kessler, Tofil, Hunt,
Nadkarni, Cheng, INSPIRE CPR Investigators Quality of CPR within
simulated cardiac arrest and influence of JIT training and feedback.

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Poster presentation at International Pediatric Simulation Society Meeting, Vancouver, 2015
8. Cheng A, Hunt EA, Grant D et al, for the INSPIRE CPR Investigators. Quality of CPR Provided
During Simulated Cardiac Arrest Across 9 Pediatric Institutions. International Pediatric Simulation
Symposium and Workshops. Vancouver, Canada, May 2015
9. Cheng A, Overly F, Kessler D et al, for the INSPIRE CPR Investigators. Perception of CPR Quality:
Influence of CPR Feedback, Just-in-Time CPR Training and Provider Role. International Pediatric
Simulation Symposium and Workshops. Vancouver, Canada, May 2015
10. Brown L, Tofil N, Overly F, Lin Y, Duff J, Bhanji F, Nadkarni V, Hunt EA, Charnovich A, Kessler D,
Bank I, Cheng A for the INSPIRE CPR Investigators. The Effect of a CPR Feedback Device on
Provider Workload during a Simulated Pediatric Cardiac Arrest. International Pediatric Simulation
Symposium and Workshops. Vancouver, Canada, May 4, 2015
11. Lin Y, Nadkarni V, Kissoon N, Currie G, Cheng A. Improved CPR Quality and Cost-Effectiveness
with a New CPR Training Curriculum. International Pediatric Simulation Symposium and
Workshops. Vancouver, Canada, May 4, 2015
12. Stoeter R, Doherty C, Fullwood C, Cheng A, Nadkarni V, Stenfors-Hayes T, Mackinnon R. Self-
directed learning using an infant manikin improves and maintains infant CPR performance.
International Pediatric Simulation Symposium and Workshops. Vancouver, Canada, May 4, 2015
13. Stoeter R, Doherty C, Fullwood C, Cheng A, Nadkarni V, Stenfors-Hayes T, Mackinnon R.
Predictors of high quality CPR performance in the workplace on an infant manikin feedback
device. International Pediatric Simulation Symposium and Workshops. Vancouver, Canada, May
4, 2015
14. Ruscica A, Kessler D. Impact of a Novel Card on Formative Feedback Provided To Residents in the
Pediatric Emergency Department. Poster presentation at Pediatric Academic Society Meeting,
San Diego, 2015
15. Auerbach, A. Comparing Pediatric Acute Care Delivery Across a Spectrum of Emergency
Departments. Poster presentation at Pediatric Academic Society Meeting, San Diego, 2015
16. Xiao S, Nadkarni L, Ford B, Kessler D. Keepin' Time With "Stayin' Alive:" Assessing the Use of a
Musical Mnemonic To Teach CPR Compression Rate.
Poster presentation at the Pediatric Academic Society Meeting, San Diego, 2015
Poster presentation at Pediatric Research Day, Columbia University, 2015
17. Zaveri P, Kou M, Stryjewski G, Van Ittersum W, McAninch B, Auerbach M, Chang T, Kessler D
Improving Infant Lumbar Puncture Clinical Outcomes Among Novices. Poster presentation at the
Pediatric Academic Society Meeting, San Diego, 2015
18. Cheng A, Brown L, Duff J, Davidson J, Overly F Tofil N, Peterson D, Whie M, Bhanji , Bank I,
Gottesman R, Adler M, Zhong J, Grant V, Grant D, Sudikoff S, Marohn K, Charnovich A, Hunt E,
Kessler D, Wong H, Robertson N, Lin J, Ouynh D, Nadkarni V. Improving CardioPulmonary
Resuscitation with a CPR Feedback Device And Refresher Simulations (CPRCARES Study): A
Multicenter, Randomized Trial. Oral presentation at the 15th Annual International Meeting on
Simulation in Healthcare (IMSH), New Orleans, Louisiana, January, 2015 Best abstract
Poster presentation, Royal College of Physicians and Surgeons Simulation Summit in Toronto,
Canada. Best abstract Award.
19. Donoghue A, Brown L, Tofil N, Cheng A. Quantifying Clinical Performance during Simulated
Pediatric Cardiac Arrest. International Meeting for Simulation in Healthcare, New Orleans, USA,
Jan 10, 2015.

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20. Cheng A, Brown L, Duff J, Davidson J, Overly F, Tofil N, Peterson D, White M, Bhanji F, Bank I,
Gottesman R, Adler M, Zhong J, Grant V, Grant D, Sudikoff S, Marohn K, Charnovich A, Hunt E,
Kessler D, Wong H, Robertson N, Lin Y, Doan Q, Duval-Arnould J, Nadkarni V for the INSPIRE CPR
Investigators. Improving CardioPulmonary Resuscitation with a CPR Feedback Device and
Refresher Simulations (CPR CARES Study): A Multicenter,Randomized Trial. International Meeting
for Simulation in Healthcare, New Orleans, USA, Jan 10, 2015
21. Auerbach, M. Mobile Outreach Simulation. Workshop at the 15th Annual International Meeting
on Simulation in Healthcare (IMSH), New Orleans, Louisiana, January, 2015.
22. Thai, Sutton, Mclario, Cross, Warkentine, Wiedemann, Foster, Kessler, Horowitz, Abo, Cohen,
Kim. Cost-effectiveness of Implementation of Point-of-care Ultrasound in a Pediatric Emergency
Department. Oral presentation at SOEM, AAP, San Diego, California, October, 2014
23. Kessler D, Auerbach M, Fein D, Chang T, Lee M, Mehta R, Gerard J, Trainor J, Pusic M.
Implementation and Impact of a Just‐in‐Time Assessment to Determine Intern Readiness to
Perform Their First Infant Lumbar Puncture.
Oral presentation at SOEM, AAP, San Diego, California, October, 2014
Poster presentation at the 15th Annual International Meeting on Simulation in Healthcare
(IMSH), New Orleans, Louisiana, January, 2015
24. Cheng A, Brown L, Duff J, Davidson J, Overly F, Tofil N, Peterson D, White M, Bhanji F, Bank I,
Gottesman R, Adler M, Zhong J, Grant V, Grant D, Sudikoff S, Marohn K, Charnovich A, Hnt E,
Kessler D, Wong H, Robertson N, Lin Y, Doan Q, Duval-Arnould J, Nadkarni V for the INSPIRE CPR
Investigators. Improving CardioPulmonary Resuscitation with a CPR Feedback Device and
Refresher Simulations (CPR CARES Study): A Multicenter,Randomized Trial. Royal College of
Physicians and Surgeons of Canada Simulation Summit, Toronto, Canada, Sept 11, 2014
Peer Reviewed Publications 2014-2015
1. Chime N, Katznelson J, Gangadharan S, Walsh B, Lobner K, Brown L, Gawel M, Auerbach MA.
Comparing Practice Patterns between Pediatric and General Emergency Medicine Physicians: A
Scoping Review. Pediatric Emergency Care. In Press 2015
2. Cheng A, Hunt EA, Grant D, Lin Y, Duff J, White ML, Peterson DT, Zhong J, Grant V, Gottesman R,
Sudikoff S, Doan Q, Nadkarni V for the INSPIRE CPR Investigators. Variability in Quality of Chest
Compressions Provided During Simulated Cardiac Arrest Across Nine Pediatric Institutions.
Resuscitation, published Sept 25, 2015. doi: 10.1016/j.resuscitation.2015.08.024.
3. MacKinnon RJ, Stoeter R, Doherty C, Fullwood C, Cheng A, Nadkarni V, Stenfors-Hayes T, Chang
TP. Self-motivated learning with gamification improves CPR performance, a randomised
controlled trial. BMJ STEL, published Oct 6, 2015. doi:10.1136/bmjstel-2015-000061.
4. Kessler DO, Walsh B, Whitfill T, Gangaharan S, Gawel M, Brown L, Auerbach MA. Disparities in
Adherence to Pediatric Sepsis Guidelines across a Spectrum of Emergency Departments: a
multicenter, cross sectional observational in-situ simulation study. Journal of Emergency
Medicine. E-publication September 2015.
5. Eppich W, Hunt EA, Duval-Arnould J, Siddall VJ, Cheng A. Structuring feedback and debriefing to
achieve mastery learning goals. Academic Medicine, published Sept 11, 2015. doi:
10.1097/ACM.0000000000000934.

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6. Sawyer T, White M, Zaveri P, Chang TP, Ades A, French H, Anderson J, Auerbach M, Johnston L,
Kessler D. Learn, See, Practice, Prove, Do, Maintain: An Evidence-based pedagogical Framework
for Procedural Skill Training in Medicine. Academic Medicine 2015 ePub. PMID 25881645.
7. Auerbach, M, Chang T, Reid J, Quinones C, Krantz A, Pratt A, Gerard J, Mehta R, Pusic M, Kessler
D. Are Pediatric Interns Prepared to Perform Infant Lumbar Punctures?: A Multi-Institutional
Descriptive Study. Pediatric Emergency Care 29(4), 453-457.
8. Doughty C, Kessler D, Zuckerbraun N, Stone K, Reid J, Kennedy C, Nypaver M, Auerbach M.
Simulation in Pediatric Emergency Fellowships. Pediatrics. 2015 Jun 8. pii: peds.2014-4158. [Epub
ahead of print]
9. Cheng A, Grant V, Dieckmann P, Arora S, Robinson T, Eppich W. Faculty Development for
Simulation Programs: 5 Issues for the Future of Debriefing Training. Simulation in Healthcare.
2015; 10(4):217-222.
10. Bank I, Cheng A, McLeod P, Bhanji F for the Pediatric Emergency Medicine
Simulation Consensus Group. Determining Content for a Simulation-Based
Curriculum in Pediatric Emergency Medicine: Results from a National Delphi
Process. Canadian Journal of Emergency Medicine, Published online May 20,
2015, DOI: http://dx.doi.org/10.1017/cem.2015.11
11. Kessler D, Pusic MV, Chang TP, Fein DM, Grossman D, Mehta R, White M,
Jang J, Whitfill T, Auerbach M; INSPIRE LP investigators. Impact of Just-
in-Time and Just-in-Place Simulation on Intern Success with Infant Lumbar
Puncture. Pediatrics 2015 May;135(5):e1237-46. PMID: 25869377.
12. Eppich W, Cheng A. How Cultural Activity Theory (CHAT) can Inform Debriefing
of Inter-Professional Team Simulations. Clinical Simulation in Nursing. 2015;
11(8):383-389.
13. Shefrin A, Khazei A, Cheng A. Realism of Procedural Task Trainers in a Pediatric
Emergency Medicine Procedures Course. Canadian Medical Education Journal. 2015; 6(1):e68-
e73.
14. Cheng A, Lockey A, Bhanji F, Lin Y, Hunt EA, Lang E. The Use of High-Fidelity Manikins for
Advanced Life Support Training – A Systematic Review and Meta-Analysis. Resuscitation. 2015;
93:142-9.
15. Lin Y, Cheng A. The Role of Simulation for Teaching Pediatric Resuscitation: Current Perspectives.
Advances in Medical Education and Practice. 2015; 6:239-248.
16. Lee J, Cheng A, Allain D, Angelski C, Ali S. High Fidelity Simulation in Pediatric Emergency
Medicine: A National Survey of Facilitator Comfort and Practice. Pediatric Emergency Care. 2015;
31(4):260-265.
17. Cheng A, Grant V, Auerbach M. Using Simulation to Improve Patient Safety: Dawn of a New Era.
JAMA Pediatrics. 2015; 169(5):419-420.
18. Jones A, Lin Y, Nettel-Aguirre A, Gilfoyle E, Cheng A. Visual Assessment of CPR Quality During
Pediatric Cardiac Arrest: Does Point of View Matter? Resuscitation. 2015; 90:50-55.
19. Eppich W, Cheng A. Promoting Excellence and Reflective Learning in Simulation (PEARLS):
Development and Rationale for a Blended Approach to Health Care Simulation Debriefing.
Simulation in Healthcare. 2015;10(2):106-115.
20. Cheng A, Palaganas J, Rudolph J, Eppich W, Robinson T, Grant VG. Co-Debriefing for Simulation-
Based Education – A Primer for Facilitators. Simulation in Healthcare. 2015;10(2):69-75.

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21. Cheng A, Donoghue A, Bhanji F. Incorporating Real-Time CPR Feedback and Quantitative CPR
Debriefings into Advanced Life Support Courses: Luxury or Necessity? Resuscitation. 2015; 90:e3-
e4.
22. Eppich W, Cheng A. Competency-Based Simulation Education: Should Competency Standards
Apply to Simulation Educators? BMJ Simulation and Technology Enhanced Learning. 2015; 1:3-4.
23. Cheng A, Overly F, Kessler D, Nadkarni V, Lin Y, Doan Q, Duff J, Tofil N, Bhanji F, Adler M,
Charnovich A, Hunt E, Brown L, for the International Network for Simulation-based Pediatric
Innovation, Research, Education (INSPIRE) CPR Investigators, Perception of CPR quality: Influence
of CPR feedback, Just-in-Time CPR training and provider role. Resuscitation 201, (87), 44-50,
February 2015.
24. Cheng A, Brown LL, Duff JP, Davidson J, Overly F, Tofil NM, Peterson DT, White ML, Bhanji F, Bank
I, Gottesman R, Adler M, Zhong J, Grant V, Grant DJ, Sudikoff ST, Marohn K, Charnovich A, Hunt
EA, Kessler DO, Wong H, Robertson N, Lin Y, Doan Q, Duval-Arnould JM, Nadkarni VM; for the
International Network for Simulation-Based Pediatric Innovation, Research, & Education
(INSPIRE) CPR Investigators: Improving cardiopulmonary resuscitation with a CPR feedback device
and refresher simulations (CPR CARES Study). JAMA Pediatrics 169(2): 137-144, February 2015.
25. Chang TP, Kwan KY, Liberman D, Song E, Dao EH, Chung D, Morton I, Festekjian A. Introducing
Teamwork Challenges in Simulation Using Game Cards. Simul Healthc 2015 ePub. PMID:
25932705.
26. Doughty C, Welch-Horan T, Hsu D, Fielder E, Pereira F, Little-Wienert K, Kaziny B, McManemy J,
Lemke D. Rapid Cycle Deliberate Practice Pediatric Simulation Scenarios. MedEdPORTAL
Publications; 2015. Available from: https://www.mededportal.org/publication/
10134http://dx.doi.org/10.15766/mep_2374-8265.10134
27. Knight, L, Gabhart, J, Earnest, K et al. (2014): “Improving Code Team Performance and Patient
Survival Outcomes: Implementation of Composite Resuscitation Team Training.” Critical Care
Medicine, 40 (2), 246-258.
28. Braun C, Kessler D, Auerbach M, Mehta R, Scalzo A, Gerard J. "Can Residents Assess Other
Providers' Infant Lumbar Puncture Skills? Validity Evidence for a Global Rating Scale and
Subcomponent Skills Checklist". Pediatric Emerg Care. Accepted November 2014.
29. Tiyyagura G, Balmer D, Chaudoin L, Kessler D, Khanna K, Srivastava G, Chang T, Auerbach M. "The
Greater Good: How Supervising Physicians Make Entrustment Decisions in the Pediatric
Emergency Department." Academic pediatrics 14, no. 6 (2014): 597-602.The Greater Good: How
Supervising Physicians Make Entrustment Decisions in the Pediatric Emergency
Department. Academic pediatrics, 14(6), 597-602.
30. Cheng A, Raemer DB. Is Clinical Trial Registration for Simulation-Based Research Necessary?
Simulation in Healthcare. 2014;9(6):350-352.
31. Mullan P, Kessler D, Cheng A. Educational Opportunities with Postevent Debriefing. The Journal
of the American Medical Association. 2014;312(22):2333-2334.
32. Kessler D, Mullan P, Cheng A. Debriefing in the Emergency Department after Clinical Events: A
Practical Guide. Annals of Emergency Medicine. 2014; 65(6):690-698.
33. Qayumi K, Pachev G, Zheng B, Ziv A, Koval V, Badiei S, Cheng A. Status of Simulation in Healthcare
Education: An International Survey. Advances in Medical Education and Practice. 2014;28(5):457-
467.

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34. Cheng A, Eppich W, Grant V, Sherbino J, Zendejas-Mummert B, Cook D. Debriefing for
Technology-Enhanced Simulation: A Systematic Review and Meta-Analysis. Medical Education.
2014;48(7):657-666.
35. Cheng A, Auerbach M, Chang T, Hunt EA, Pusic M, Nadkarni V, Kessler D. Designing and
Conducting Simulation-based Research. Pediatrics. 2014; 133(6): 1091-1101.
36. Cheng A, Lang T, Starr S, Pusic M, Cook D. Technology-Enhanced Simulation and Pediatric
Education: A Meta-Analysis. Pediatrics. 2014;133(5):e1313-e1323.