Assistant Professor McGovern Medical School at the University of Texas Health Science Center at Houston Houston, Texas, United States
Background: The format of pediatric resident teaching is changing. There has been a shift to increase experience as an outpatient clinician and decrease time spent in the hospital setting[1]. The complexity, acuity, and volume of patients in the hospital however, has not changed and in many areas may continue to rise. This paradigm shift makes it important to augment a pediatric resident’s learning through alternative means. Objective: Gamified learning is well proven to be effective for teaching cognitive skills[2,3]. Studies are needed to see if gamification can teach leadership, delegation, and triaging skills. These attributes have traditionally been taught through experience and practice. We present a low fidelity simulation game utilizing card based scenarios and facilitated debriefs that can be quickly adopted by any program to teach those intangible skills that are vital to the functioning of any physician in the acute care setting. Design/Methods: 19 First year residents in the categorical pediatric, medicine/pediatric, pediatric neurology, and medical genetics residency program were paired and asked to participate in Card Based Training for Pediatrics (CBT-P). The teams each assessed a randomized set of clinical scenarios of a pre-set variety of acuity and were instructed to rank their scenarios from highest to lowest acuity and what staff/resources were needed to handle the situation. The group then debriefed together. During the debrief, the teams were scored by the faculty facilitator as to how competently they managed their team. The competency scores were designed by a consensus of PhD medical educators and faculty clinicians in pediatric hospital medicine and pediatric emergency medicine to correspond to each section of the pre and post self-assessment scores. Confidence scores were assessed with a paired T-analysis for each question. A total of 16 data points were included based on inclusion criteria and completion of the surveys. Results: Despite the small data set interns reported increased confidence in triaging, clinical resource management, and task delegation after playing CBT-P once or twice (p < 0.05 in 3 out of 6 domains). The sample size is too small to correlate competence effectively.
Conclusion(s): Low fidelity card based training simulating the pediatric floor could be a helpful tool to improve triaging and delegation skills of pediatric residents. More study is required to determine at what point in training it is most helpful and to validate the scoring tool.
