International Pediatric Emergency Medicine and Critical Care Fellow Education: Utilizing Virtual Resuscitation Simulation in Settings With Differing Resources

Maloney, Christine E; Burns, Rebekah; Hartford, Emily A.; Arnim, Amélie von Saint André-von; Foohey, Sarah; Kailemia, Mukokinya; Reel, Bhupi; Thomas, Anita

doi:10.7759/cureus.21991

Cited by 3 publications

(2 citation statements)

References 6 publications

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“…After completing the CCCQ, Yale PEM fellows were assigned as facilitators for simulation sessions with Indus EM learners in Pakistan. The PEM curriculum was delivered using a computer-based and synchronously controlled simulation platform utilizing the Virtual Resuscitation Room (VRR), 18,19 which is a free, interactive, and collaborative online simulation education platform. It uses Google slides and the Zoom platform, 20 which allowed for synchronous, interactive, low-cost simulation activities with learners in Pakistan and facilitators at Yale (Figure 1).…”

Section: Educational Interventionmentioning

confidence: 99%

Exploring cultural sensitivity during distance simulations in pediatric emergency medicine

Fayyaz,

Jaeger,

Takundwa

et al. 2023

AEM Education and Training

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BackgroundCultural sensitivity (CS) training is vital to pediatric emergency medicine (PEM) curricula. This study aimed to explore CS in Yale PEM fellows and emergency medicine (EM) residents at Indus Hospital and Health Network (IHHN) in Pakistan through distance simulation activities.MethodsThis mixed‐methods analysis of an educational intervention was conducted at Yale University in collaboration with IHHN. We approached seven U.S. PEM fellows and 22 Pakistani EM residents. We performed a baseline CS assessment using the Clinical Cultural Competency Questionnaire (CCCQ). Afterward, the U.S. PEM fellows facilitated the Pakistani EM residents through six distance simulation sessions. Qualitative data were collected through online focus groups. The CCCQ was analyzed using descriptive statistics, and content analysis was used to analyze the data from the focus groups.ResultsSeven U.S. PEM fellows and 18 of 22 Pakistani EM residents responded to the CCCQ at the beginning of the module. The mean (±SD) CCCQ domain scores for the U.S. PEM fellows versus the Pakistani EM residents were 2.56 (±0.37) versus 2.87 (±0.72) for knowledge, 3.02 (±0.41) versus 3.33 (±0.71) for skill, 2.86 (±0.32) versus 3.17 (±0.73) for encounter/situation, and 3.80 (±0.30) versus 3.47 (±0.47) for attitude (each out of 5 points). Our qualitative data analysis showed that intercultural interactions were valuable. There is a common language of medicine among the U.S. PEM fellows and Pakistani EM residents. The data also highlighted a power distance between the facilitators and learners, as the United States was seen as the standard of “how to practice PEM.” The challenges identified were time differences, cultural practices such as prayer times, the internet, and technology. The use of local language during debriefing was perceived to enhance engagement.ConclusionThe distance simulation involving U.S. PEM fellows and Pakistani EM residents was an effective approach in assessing various aspects of intercultural education, such as language barriers, technical challenges, and religious considerations.

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Section: Educational Interventionmentioning

confidence: 99%

Exploring cultural sensitivity during distance simulations in pediatric emergency medicine

Fayyaz,

Jaeger,

Takundwa

et al. 2023

AEM Education and Training

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“…Hence, in settings with high rates of malnutrition, such as the Philippines, practitioners must learn not only to recognize shock, but also to evaluate nutritional status and perform frequent patient reassessments to guide fluid management. Although there are several published simulation-based curricula focused on hypovolemic shock in pediatric patients [2,32,33], there are few publications evaluating curricula focused on shock of any kind in pediatric patients with co-morbid malnutrition in RLS [34,35].…”

Section: Introductionmentioning

confidence: 99%

Implementation and evaluation of a shock curriculum using simulation in Manila, Philippines: a prospective cohort study

Yelton

Ramos²,

Reuland

et al. 2022

BMC Med Educ

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Background Shock causes significant morbidity and mortality in children living in resource-limited settings. Simulation has been successfully used as an educational tool for medical professionals internationally. We sought to improve comfort and knowledge regarding shock recognition and fluid management by implementing a pediatric shock curriculum using simulation as an assessment for trainees in Manila, Philippines. Methods We assessed a shock curriculum focused on patients with malnutrition in a prospective cohort study, using a written test and a videotaped simulation-based objective standardized clinical examination. Implementation occurred in March 2020 with 24 Filipino pediatric residents at a single institution in Manila. Outcomes included time to initiation of fluid resuscitation, improvement in confidence, knowledge on a written assessment, and performance in simulation. Results were compared pre- and post-intervention using Wilcoxon signed-rank test. Results The time to initiation of fluids did not change between the baseline simulation (median [interquartile range] = 71.5 seconds [52–116.5]) and the final simulation (68 seconds [52.5–89]; P = 0.42). Confidence in identifying shock and malnutrition, managing hypovolemic shock, managing septic shock, and placing intraosseous access all increased (P < 0.01) post-intervention. Written test scores showed no improvement, but performance in simulation, measured using a checklist, improved from a total score of 10 [8.5–11] to 15 [13-16] (P < 0.01). Conclusion In our study of a simulation-based shock education program, we showed improvement in confidence and knowledge as measured by a resuscitation checklist. It is feasible to establish a successful simulation-based education program in a low-resource setting.

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The Changing Landscape of Global Child Health Education in the United States and the Effects of the COVID-19 Pandemic and Civil Unrest

Bjorklund,

Muttineni,

Gladding

et al. 2023

Pediatr Ann

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The events of recent years have affected the landscape of global child health education (GCHE) in the United States. War, racism, forced displacement, and the coronavirus disease 2019 (COVID-19) pandemic had global repercussions that reached US GCHE. The aim of this article is to examine the effect of these events on the landscape of GCHE in the US. Key areas of GCHE have been reframed, reshaped, and accelerated by these events. Travel restrictions accelerated virtual learning opportunities. Core curriculum needed to be reconsidered to address antiracism, equity, and decolonization. Expansion of GCHE activities, including local-global electives, was needed to meet increased resident demand and help address local community needs. Inequities in international partnerships were further highlighted, requiring new approaches. Global research education and practices were also affected with a rapid expansion in virtual opportunities and further development of education in equitable research practices. [ Pediatr Ann . 2023;52(9):e324–e329.]

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International Pediatric Emergency Medicine and Critical Care Fellow Education: Utilizing Virtual Resuscitation Simulation in Settings With Differing Resources

Cited by 3 publications

References 6 publications

Exploring cultural sensitivity during distance simulations in pediatric emergency medicine

Exploring cultural sensitivity during distance simulations in pediatric emergency medicine

Implementation and evaluation of a shock curriculum using simulation in Manila, Philippines: a prospective cohort study

The Changing Landscape of Global Child Health Education in the United States and the Effects of the COVID-19 Pandemic and Civil Unrest

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