Simulation for Pediatric Hospital Medicine

Abstract

Pediatric hospital medicine is a rapidly evolving field that encompasses a great breadth and depth of pediatrics. Over the past decade, there has been a rise in the number of patients admitted to children’s hospitals with the greatest increase seen in children with complex, chronic medical conditions. Medical acuity in hospitalized children has also risen over this time frame. To meet the needs of this growing population, inpatient care providers must effectively collaborate to deliver timely and high-quality care. Simulation is an educational modality that can help providers hone teamwork skills during challenging medical situations. In this chapter, we present three models for simulation programs that are contextualized to the inpatient setting. The first model is just-in-time simulation in which scenarios are based on a real patient who is at risk for deterioration. The participants are the actual people who are caring for this patient. By rehearsing targeted management strategies in advance, there is potential to improve patient outcomes. A second inpatient simulation program model is a mock code program. The focus is on simulating urgent scenarios, often with activation of multiple health-care teams including the code team. Systemic issues impeding care delivery are identified and discussed as a multidisciplinary group. The third model is a continuing professional development program geared towards an interprofessional group of staff learners. A comprehensive, needs-based simulation curriculum is developed to reflect the full spectrum of pediatric inpatient care, including the more common urgent precode situation to the less frequent life-threatening types of deterioration. These three simulation program models will hopefully serve as a framework for creating a feasible and sustainable simulation program for inpatient pediatric care teams.