1. • Pediatric trauma and resuscitations: high-stakes, low-frequency,
quality of care difficult to assess
• There are few data exploring the relationship of simulation
performance to performance on real patients
• The validity of the assessment of simulated performance as a
surrogate for clinical performance needs further investigation
Background
• To compare time to performance of interventions in simulated
to real patient cases
• n= 22 real patient cases and 11 simulated cases
• No difference in TTI between simulated and clinical cases for obtain SAMPLE history,
circulation assessment, airway assessment, cardiorespiratory/O2 monitors placed,
verbalize vital signs, O2 administration, order consults/imaging
• Simulation faster for IV placement and estimating/obtaining patient weight
• Insufficient data for check dextrose, apply defibrillator pads, discharge defibrillator,
initiate airway RSI, insert endotracheal tube
• Design: Prospective comparative study
• Setting: Level 1 pediatric emergency department
• Inclusion: Real (R): level 1 & 2 triage patients ≤18 y/o
Simulated (S): in-situ simulated patients both in and
outside of Yale
• Collection period: June 2013-present
• Subjects: Interdisciplinary pediatric emergency teams
• Assessments: Time-to-intervention (TTI) = elapsed time from
patient arrival (t0) to performance of intervention
• Interventions assessed: obtain SAMPLE history, circulation
assessment, airway assessment, cardiorespiratory/O2 monitors
placed, verbalize vital signs, place IV, estimate/obtain patient
weight, O2 administration, order consults/imaging, check
dextrose, apply defibrillator pads, discharge defibrillator,
initiate airway RSI, insert endotracheal tube
Lucas Butler, Anup Agarwal MBBS, Jaewon Jang PhDc, Marc Auerbach MD
Yale School of Medicine
Yale-New Haven Children’s Hospital, Pediatric Emergency Medicine Department
Objective
Methods
ConclusionsAssessment Tool
Future Directions
Acknowledgements
• Performance in simulation is similar to real patient performance
• TTI’s measured using novel iCODA checklist-stop watch application developed in
collaboration with Studiocode™
Limitations
Results
• Small sample size
• Performance measured solely via TTI, without qualitative
assessment of performance
• Confounding variables not measured—team size and
composition, case type
• These data support simulation performance assessment as
surrogate for real patient performance
• Use of video review to improve data collection accuracy
• Inclusion of qualitative data collection
• Funding Source: Vernon W. Lippard, M.D. Medical Student Research
Fellowship, Yale University School of Medicine
• We would like to thank Mike Anzalone of Studiocode™ for development
and aid with the iCODA application
• We would like to thank Dr. John Forrest & associates at the YSM Office
of Student Research
• For questions, please contact lucas.butler@yale.edu