161 - Evaluating the Impact of a Structured Simulation Curriculum on Pediatric Resident Knowledge, Confidence, and Performance in Critical Care Scenarios

Publication Number: 4158.161

Samantha Ribeiro, Upstate Golisano Children’s Hospital, SUNY Upstate Medical University, Syracuse, NY, United States; Jennifer C. Zuccaro, Golisano Children’s Hospital at SUNY Upstate, Syracuse, NY, United States; Lauren Waichenberg, SUNY Upstate Medical University, Syracuse, NY, United States; Phillip Mackewicz, Upstate Golisano Children's Hospital, Syracuse, NY, United States; Susan Wojcik, SUNY Upstate Medical University, Syracuse, NY, United States

Background: Life-threatening emergencies such as cardiopulmonary arrest ("codes") are rare in pediatrics; however, pediatric providers must be prepared to manage them effectively. Simulation-based education (SIM) has become an essential strategy to enhance performance and decision-making during these high-stress scenarios. Prior studies show SIM improves provider performance and resuscitation outcomes, though benefits may decline over time, emphasizing the need for ongoing structured training.

Objective: To evaluate whether a longitudinal simulation curriculum improves pediatric residents' knowledge of Pediatric Advanced Life Support (PALS) algorithms, comfort managing critically ill patients, and perceptions of simulation as an educational tool.

Design/Methods: This prospective educational study was integrated into the pediatric residency curriculum at Upstate Golisano Children's Hospital. Residents completed five monthly simulation sessions (critical illness, shock, tachycardia, bradycardia, cardiac arrest) in small randomized groups (3-7 learners), completing each scenario once.
Data were collected in REDCap through pre- and post-curriculum assessments with knowledge questions and Likert-scale items on confidence, teamwork, and educational value. After each session, residents completed a brief survey on clarity of objectives, instructional effectiveness, comfort managing critical scenarios, and perceived value. Only residency year was recorded; no other identifying information was collected.

Results: Sixty-six residents completed post-simulation surveys; with one exclusion, resulting in 65 respondents (Figure 1). Most residents agreed simulation was effective: 95.4% reported clear objectives and skill acquisition, 92.5% noted increased comfort managing critically ill patients, 98.5% endorsed improved communication, and 95.5% rated simulation as an effective teaching method. The pre-curriculum test was distributed to 45 residents, with 37 responses (82%). The post-curriculum test was completed by 27 residents (73%), with an overall paired response rate of 60%. Knowledge scores improved significantly from 48.2% ± 21.8 to 70.9% ± 21.2, a 22.8% ± 25.8-point increase (p < 0.001; Cohen's d = 0.88). PGY-level distribution for knowledge respondents is shown in Figure 2.

Conclusion(s): A structured, longitudinal simulation curriculum was associated with strong learner satisfaction, improved knowledge, and sustained confidence in managing pediatric emergencies. This supports simulation as an effective method to improve resuscitation readiness and clinical competency.

Figure 1. Simulation Participants by PGY Level
Distribution of pediatric residents participating in the simulation curriculum by postgraduate year (PGY 1-3)

Figure 2. Residents Completing Pre- and Post-Tests by PGY Level
Comparison of PGY-level distribution of residents who completed the pre-curriculum and post-curriculum knowledge assessments.