Acute care of pediatric patients with sickle cell disease: A simulation performance assessment

Tracy L. Burns, Michael R. Debaun, John R. Boulet, Gayle Smink, David J. Murray, James J. Fehr

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: Sickle cell disease (SCD) is a rare disorder with cardinal features including hospitalization for vaso-occlusive pain episodes, acute pulmonary injury, and increased infection rates. For physician-trainees, learning optimal SCD management is challenging because of limited exposure to life threatening complications requiring timely interventions. Procedure: To create, demonstrate reliability, and validate simulation-based, acute care SCD scenarios for physician-trainees, seven scenarios were derived from SCD patient cases. For each scenario, participants had 5 minutes to complete diagnostic and treatment interventions. Participants were divided into two groups based on clinical experience: interns or residents/fellows. Two raters scored performances using diagnostic and therapeutic checklists-indicating whether specific actions were performed and a global, 1 (poor) to 9 (excellent), rating. Scenario scores were calculated by averaging rater scores on each metric. Reliability was defined through uniformity in rater scoring and consistency of participant performance over scenarios. Validity was demonstrated by the performance gradient where the more experienced trainees outperform those early in training. Results: Twenty-eight pediatric residents and hematology fellows took part in the study. Reliability for assessment scores overall was moderate. Performance on all but one scenario was moderately predictive of overall performance. Senior resident/fellows performed significantly better than interns. Positive associations existed between overall performance scores (P<0.01) and months of postgraduate training (P<0.01). Conclusions: Mannequin-based simulation is a novel method for teaching pediatric residents SCD-specific acute care skills. The assessment provided reliable and valid measures of trainees' performance. Further studies are needed to determine simulation's utility in education and evaluation.

Original languageEnglish (US)
Pages (from-to)1492-1498
Number of pages7
JournalPediatric Blood and Cancer
Volume60
Issue number9
DOIs
StatePublished - Sep 1 2013

Fingerprint

Sickle Cell Anemia
Patient Care
Pediatrics
Manikins
Physicians
Acute Lung Injury
Hematology
Disease Management
Checklist
Teaching
Hospitalization
Learning
Education
Pain
Therapeutics
Infection

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology

Cite this

Burns, Tracy L. ; Debaun, Michael R. ; Boulet, John R. ; Smink, Gayle ; Murray, David J. ; Fehr, James J. / Acute care of pediatric patients with sickle cell disease : A simulation performance assessment. In: Pediatric Blood and Cancer. 2013 ; Vol. 60, No. 9. pp. 1492-1498.
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Acute care of pediatric patients with sickle cell disease : A simulation performance assessment. / Burns, Tracy L.; Debaun, Michael R.; Boulet, John R.; Smink, Gayle; Murray, David J.; Fehr, James J.

In: Pediatric Blood and Cancer, Vol. 60, No. 9, 01.09.2013, p. 1492-1498.

Research output: Contribution to journalArticle

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