162 - Enhancing Pediatric Education Through Multidisciplinary, In-Situ Simulation of Acute Pediatric Care Scenarios

Publication Number: 4159.162

Thao L. Nguyen, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, TX, United States; Mitchell Moore, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, TX, United States; Yogesh Bangale, Children's Memorial Hermann Hospital, Houston, TX, United States; Kristen Webber, Children's Memorial Hermann Hospital, Houston, TX, United States; Jennifer Nguyen, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, TX, United States; Upulie Nawaratne, McGovern Medical School at the University of Texas Health Science Center at Houston, houston, TX, United States

Background: Medical simulation (SIM) is a well-established educational tool for teaching resuscitation, procedural skills, communication, and team-based care. We expanded an existing pediatric SIM program to deliver recurring, in-situ acute care scenarios emphasizing multidisciplinary collaboration among nurses, respiratory therapists, general pediatric residents, and pediatric critical care fellows. Conducting simulation in the actual clinical environment enhances realism and learner engagement.

Objective: This quality improvement project aims to improve teamwork, communication, and learner confidence in managing acute pediatric events through multidisciplinary in-situ simulations and structured debriefings.

Design/Methods: Over 12 months, monthly in-situ simulations were conducted across pediatric inpatient units (intensive care, intermediate care, and medical/surgical floors). Four rotating scenarios-septic shock, status epilepticus, traumatic hemorrhagic shock, and status asthmaticus-progressed to cardiac arrest. Simulations began with bedside nurse assessment and resident-led resuscitation, transitioning to fellow leadership. Each session concluded with a structured debrief focused on teamwork and clinical decision-making. Participants completed anonymous pre- and post-SIM surveys using a 5-point Likert scale to assess perceived benefits (Table 1). Paired responses were analyzed using descriptive statistics and paired t-tests.

Results: Across 12 sessions, 63 pre-SIM and 71 post-SIM surveys were collected (RNs: 34.9%/43.7%, RTs: 9.5%/9.9%, residents: 44.5%/38.0%, fellows: 11.0%/8.4%). In pre- and post-SIM surveys, participants generally agreed or strongly agreed (Likert 4 or 5) that SIM improved teamwork, communication, clinical performance, interdisciplinary collaboration, and confidence. Paired analysis (n=27) showed statistically significant increases in mean Likert scores post-SIM (p < 0.05, Table 2). Debriefing was strongly endorsed as enhancing learning and reflection.

Conclusion(s): Monthly multidisciplinary in-situ simulation is a feasible and impactful educational strategy that goes beyond conventional SIM by embedding training within the clinical workflow and emphasizing interprofessional collaboration. It improved learner-reported teamwork, communication, and clinical confidence. Role transitions and structured debriefs enhanced realism and team dynamics. Future directions include increasing paired response rates, linking subjective improvements to objective metrics, and evaluating impact on clinical outcomes.

Table 1 - Likert scale survey questions
These questions were the Likert scale survey questions asked of participants. All questions were asked in post-SIM surveys, with only the starred* questions asked in pre-SIM surveys. Starred* were used in paired analysis.

Table 2: One-sided Paired-T test of common pre- and post- questions
All 5 questions showed a significant increase in perceived benefits of simulation.