Rapid Cycle Deliberate Practice Simulation Curriculum Improves Pediatric Trauma Performance

Abstract

Introduction: Simulation-based medical education allows learners to refine and maintain clinical skills especially for high-stake situations such as trauma resuscitation. Despite the primary and secondary survey being its foundation, literature shows poor adherence with overall rates as low as 13%. This study evaluates the impact of rapid cycle deliberate practice (RCDP) on primary and secondary survey skill retention. We hypothesized that RCDP-trained surgery residents will have real-world clinical improvement in their survey completion in pediatric trauma resuscitations. Methods: We developed an RCDP trauma resuscitation curriculum. Videos of trauma resuscitations before and after curriculum implementation were scored by 2 blinded reviewers using a modified Pediatric Trauma Assessment Scoring Tool. Actual trauma care by residents who had received the curriculum (study group) was compared with care provided by residents who had not received the curriculum (precurriculum historical control group and a concurrent control group who provided care without receiving the curriculum). Results: One hundred eighty-eight videos were scored with 98 in study group, 33 in concurrent control group, and 57 in historical control group. There was a significant improvement in primary survey performance between study group and historical control group (P < 0.001), but no difference between study group and concurrent control group. There was a significant improvement between study group and 2 control groups in secondary survey performance (both P < 0.001). Conclusions: The RCDP curriculum led to significant improvement in surgical residents' trauma survey performance and had clinical impact on actual patients, which is rare in pediatric trauma simulation literature.

Rapid‐cycle deliberate practice improves time to defibrillation and reduces workload: A randomized controlled trial of simulation‐based education

“…Our findings are in line with existing research on RCDP, which has shown improved performance of teams 15,17,18,32‐35 . This project showed that time to defibrillation was shorter when teams were trained using RCDP compared with PSD.…”

Rapid cycle deliberate practice to improve airway skills and performance of trainees in a pediatric emergency department

“…RCDP has been shown to improve skills in simulation settings 10,14,16–21 ; however, to our knowledge, prior to this study there has been limited evidence for translation to actual patients. One study assessed examination performance during patient care via video review compared to the simulation setting, 36 while another showed improved care in the simulation setting pre‐ and post‐RCDP airway management training but found no improvement in intubation success 17 . Our study is unique both in the creation of a novel airway training program and in demonstrating improved clinical outcomes for the patients who were intubated by trainees who participated in the program.…”

“…4 We have performed RCDP has been shown to improve skills in simulation settings 10,14,[16][17][18][19][20][21] ; however, to our knowledge, prior to this study there has been limited evidence for translation to actual patients. One study assessed examination performance during patient care via video review compared to the simulation setting, 36…”

Multidisciplinary Simulation for Blunt and Penetrating Pediatric Trauma Utilizing Standard and Rapid Cycle Deliberate Practice Models

“… 11 RCDP simulation training in pediatric trauma has demonstrated participant improvement not just in the practice setting but also in actual patient care. 12 …”