Paediatric oncology simulation training for resident education

Gayle Smink, Donna B. Jeffe, Robert J. Hayashi, Noor Al-Hammadi, James J. Fehr

Research output: Contribution to journalArticle

Abstract

Introduction We sought to evaluate paediatric oncology simulations intended to improve paediatric residents' skills and comfort in caring for children with cancer. Method In a non-randomised trial, controls (the first three rotations) received a standard set of lectures, and the intervention arm received these lectures plus five simulation training scenarios-fever/neutropaenia, a new leukaemia diagnosis, end-of-life care discussion, tumour lysis syndrome and a mediastinal mass. All residents were tested after the rotation on the first three scenarios; management skills were evaluated independently by two raters. Before and after training, all residents completed an emotional-appraisal questionnaire evaluating each scenario as a perceived challenge or threat. Analysis of variance (ANOVA) measured differences by study arm in skills checklist assessments and appraisals; repeated measures ANOVA measured changes in emotional-appraisal scores. Results Forty-two residents (9 controls, 33 interventions) participated. Inter-rater agreement for skills checklist scores using average-measures intraclass correlation was high (0.847), and overall mean scores were significantly higher for the intervention than control group across both raters (p=0.005). For all residents, perceived challenge increased in the end-of-life simulation, and perceived threat decreased in all three test scenarios. The intervention group, regardless of training year, evaluated the teaching scenarios favourably and felt that challenging oncology situations were addressed, skills were enhanced and the simulations should be offered to other residents. Conclusions It was feasible to introduce residents to difficult paediatric oncology scenarios using simulation. The intervention group performed more skills than controls when tested and perceive threat declined in all residents after their paediatric oncology rotation.

Original languageEnglish (US)
Pages (from-to)155-160
Number of pages6
JournalBMJ Simulation and Technology Enhanced Learning
Volume5
Issue number3
DOIs
StatePublished - Jul 1 2019

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Simulation Training
Oncology
Pediatrics
Education
resident
Scenarios
simulation
scenario
Analysis of variance (ANOVA)
Checklist
Analysis of Variance
education
Tumor Lysis Syndrome
Analysis of variance
Terminal Care
Simulation
threat
analysis of variance
Intraclass Correlation
Tumors

All Science Journal Classification (ASJC) codes

  • Modeling and Simulation
  • Health Informatics
  • Education

Cite this

Smink, Gayle ; Jeffe, Donna B. ; Hayashi, Robert J. ; Al-Hammadi, Noor ; Fehr, James J. / Paediatric oncology simulation training for resident education. In: BMJ Simulation and Technology Enhanced Learning. 2019 ; Vol. 5, No. 3. pp. 155-160.
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Paediatric oncology simulation training for resident education. / Smink, Gayle; Jeffe, Donna B.; Hayashi, Robert J.; Al-Hammadi, Noor; Fehr, James J.

In: BMJ Simulation and Technology Enhanced Learning, Vol. 5, No. 3, 01.07.2019, p. 155-160.

Research output: Contribution to journalArticle

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T1 - Paediatric oncology simulation training for resident education

AU - Smink, Gayle

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AU - Hayashi, Robert J.

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N2 - Introduction We sought to evaluate paediatric oncology simulations intended to improve paediatric residents' skills and comfort in caring for children with cancer. Method In a non-randomised trial, controls (the first three rotations) received a standard set of lectures, and the intervention arm received these lectures plus five simulation training scenarios-fever/neutropaenia, a new leukaemia diagnosis, end-of-life care discussion, tumour lysis syndrome and a mediastinal mass. All residents were tested after the rotation on the first three scenarios; management skills were evaluated independently by two raters. Before and after training, all residents completed an emotional-appraisal questionnaire evaluating each scenario as a perceived challenge or threat. Analysis of variance (ANOVA) measured differences by study arm in skills checklist assessments and appraisals; repeated measures ANOVA measured changes in emotional-appraisal scores. Results Forty-two residents (9 controls, 33 interventions) participated. Inter-rater agreement for skills checklist scores using average-measures intraclass correlation was high (0.847), and overall mean scores were significantly higher for the intervention than control group across both raters (p=0.005). For all residents, perceived challenge increased in the end-of-life simulation, and perceived threat decreased in all three test scenarios. The intervention group, regardless of training year, evaluated the teaching scenarios favourably and felt that challenging oncology situations were addressed, skills were enhanced and the simulations should be offered to other residents. Conclusions It was feasible to introduce residents to difficult paediatric oncology scenarios using simulation. The intervention group performed more skills than controls when tested and perceive threat declined in all residents after their paediatric oncology rotation.

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