Improving the Performance of Residents in Pediatric Resuscitation with Frequent Simulated Codes

Abstract

Aim. Exposure to real codes during pediatric residency training is scarce. Consequently, experiencing mock codes scenarios can provide an opportunity to increase residents’ confidence and knowledge in managing pediatric emergencies. Hypothesis. Pediatric senior residents perform better as code team leaders if they are exposed to frequent mock codes. Material and Methods. Forty-three pediatric senior residents (postgraduate year [PGY] two and three) participated in the study. Team leader performance was assessed utilizing the Team Emergency Assessment Measure (TEAM) scoring. Residents’ team leadership performance was assessed before and 6 months after the implementation of weekly mock codes. Results. Pediatric residents’ team leadership performance in mock codes improved after exposure to weekly practice mock code sessions (71.93 ± 18.50 vs 81.44 ± 11.84, P = 0.01). Conclusion. Increasing the frequency of mock code sessions during residency training led to an improvement in code team leadership performance in pediatric senior residents.

Review article: Use of the Team Emergency Assessment Measure in the rating of emergency teams' non‐technical skills: A mapping review

“…Team performance varied with ratings ranging from approximately 90% for experienced clinical teams down to 38% for students, with notable performance improvements following training interventions and repeated practice. There was a particular focus on leadership skills training which improved overall NTS ratings, consistent with the required role of the team leader to orchestrate the team's activities 11,30 . This clearly indicates that leadership and teamwork skills can be developed and perhaps debunks the argument that leaders are born rather than made 37 …”

“…A simulation study of 15 trained nurse teams and 32 nursing student teams in disciplinary teams of three, reported a TEAM total mean score of 57% for nurses and 38% for students when managing deteriorating patients 24 . A programme of frequent mock events enabled senior medical residents to improve their NTS and achieve a mean TEAM total score of 81.4% in the final event 11 . However, not all training interventions showed improved NTS performance.…”

“…There was a particular focus on leadership skills training which improved overall NTS ratings, consistent with the required role of the team leader to orchestrate the team's activities. 11,30 This clearly indicates that leadership and teamwork skills can be developed and perhaps debunks the argument that leaders are born rather than made. 37 Training impact was demonstrated at Levels 1-3 on Kirkpatrick's hierarchy but with no outcomes at Level 4.…”

“…24 A programme of frequent mock events enabled senior medical residents to improve their NTS and achieve a mean TEAM total score of 81.4% in the final event. 11 However, not all training interventions showed improved NTS performance. A multidisciplinary newborn emergencies workshop did not improve NTS performance in the intervention group over the control group, with mean TEAM total scores the same in both groups (35/44, 79.5%).…”

“…7 These are often described as 'human factors'. 8 These skills apply across healthcare teams, whether it be, for example, in surgical teams, 9,10 emergency teams 5,11 or healthcare students training in interprofessional settings. 12 Numerous studies have focused on the training of disciplinary and interprofessional medical and nursing teams.…”