573 - Usability and Acceptability of a Novel Frontline Pediatric Readiness Simulation Bundle in Critical Access Hospital Emergency Departments

Publication Number: 1550.573

Anne Adema, Children's Hospital Colorado, Littleton, CO, United States; Mairead Dillon, University of Colorado School of Medicine, Denver, CO, United States; Corrie E. Chumpitazi, Duke University School of Medicine, Durham, NC, United States; Bethany M.. Kwan, University of Colorado School of Medicine, Aurora, CO, United States; Marc Auerbach, Yale School of Medicine, New Haven, CT, United States; Sandra Spencer, Children's Hospital Colorado, Aurora, CO, United States; Kathleen Adelgais, University of Colorado School of Medicine, Aurora, CO, United States

Background: Emergency departments with high pediatric readiness have lower pediatric mortality, yet critical access hospitals struggle to maintain skills, equipment familiarity, and clinical knowledge due to low volumes of pediatric patients. Brief, frequent simulation training can improve performance and patient outcomes. The Frontline Pediatric Readiness Bundle (FPRB) is a suite of simulation tools designed to enhance multidisciplinary team readiness, and familiarity with evidence-based resources, medications, and equipment, yet the usability and acceptability for implementation remain unknown.

Objective: To assess the usability and acceptability of the FPRB with facilitator-provider teams at critical access hospitals

Design/Methods: This prospective study (June-October 2025) recruited multidisciplinary emergency care teams from critical access hospitals in 3 states via Emergency Medical Services for Children programs. Teams participated in 4-hour sessions completing two scenarios for each Frontline Pediatric Readiness Bundle (FPRB) tool: case-based scavenger hunts (CBSH), tabletop simulations (TTS), and a simulation app (SimP3). Usability for CBSH and TTS was assessed with the Post-Study System Usability Questionnaire (PSSUQ; satisfaction scale 1=high to 7=low). Secondary outcomes included the Acceptability of Intervention Measure (AIM), Intervention Appropriateness Measure (IAM), and Feasibility of Intervention Measure (1-5 (low-high)), and percent of simulations with identified latent safety threats and/or missing essential equipment or resources. SimP3 was assessed using the System Usability Scale (0-100), and NASA Task Load Index (0-100). SimP3 secondary outcomes included satisfaction (1-5 (low-high)), experience (1-5 (poor-very good)), and Net Promotor Score (0-10). For each outcome, mean and standard deviation were calculated using scores from all participants.

Results: A total of 78 participants from 13 teams participated (Table1). The mean PSSUQ for CBSH and TTS were 1.08 and 1.17 respectively, indicating high usability and satisfaction (Table 2). Mean acceptability, appropriateness and feasibility were high. Latent safety threats were identified in 21-40% of the CBSH, and in 8-25% of TTS simulations. Overall, users of SIMP3 reported high usability and satisfaction, low cognitive load, and overall positive experience. (Table 3).

Conclusion(s): Among a cohort of critical access hospital emergency care teams, a suite of simulation tools demonstrates high usability and acceptability. Future work is needed to assess impact on clinical performance and optimum method of dissemination and implementation.

Table 1: Participant Characteristics
Table 1: Participant Characteristics

Table 2: CBSH and TTS Usability and Acceptability
Table 2: CBSH and TTS Usability and Acceptability

Table 3: SIMP3 Usability and Acceptability
Table 3: SIMP3 Usability and Acceptability