Yale Study

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<ol><li> 1. Pediatric trauma and resuscitations: high-stakes, low-frequency, quality of care difficult to assess There are few data exploring the relationship of simulation performance to performance on real patients The validity of the assessment of simulated performance as a surrogate for clinical performance needs further investigation Background To compare time to performance of interventions in simulated to real patient cases n= 22 real patient cases and 11 simulated cases No difference in TTI between simulated and clinical cases for obtain SAMPLE history, circulation assessment, airway assessment, cardiorespiratory/O2 monitors placed, verbalize vital signs, O2 administration, order consults/imaging Simulation faster for IV placement and estimating/obtaining patient weight Insufficient data for check dextrose, apply defibrillator pads, discharge defibrillator, initiate airway RSI, insert endotracheal tube Design: Prospective comparative study Setting: Level 1 pediatric emergency department Inclusion: Real (R): level 1 &amp; 2 triage patients 18 y/o Simulated (S): in-situ simulated patients both in and outside of Yale Collection period: June 2013-present Subjects: Interdisciplinary pediatric emergency teams Assessments: Time-to-intervention (TTI) = elapsed time from patient arrival (t0) to performance of intervention Interventions assessed: obtain SAMPLE history, circulation assessment, airway assessment, cardiorespiratory/O2 monitors placed, verbalize vital signs, place IV, estimate/obtain patient weight, O2 administration, order consults/imaging, check dextrose, apply defibrillator pads, discharge defibrillator, initiate airway RSI, insert endotracheal tube Lucas Butler, Anup Agarwal MBBS, Jaewon Jang PhDc, Marc Auerbach MD Yale School of Medicine Yale-New Haven Childrens Hospital, Pediatric Emergency Medicine Department Objective Methods ConclusionsAssessment Tool Future Directions Acknowledgements Performance in simulation is similar to real patient performance TTIs measured using novel iCODA checklist-stop watch application developed in collaboration with Studiocode Limitations Results Small sample size Performance measured solely via TTI, without qualitative assessment of performance Confounding variables not measuredteam size and composition, case type These data support simulation performance assessment as surrogate for real patient performance Use of video review to improve data collection accuracy Inclusion of qualitative data collection Funding Source: Vernon W. Lippard, M.D. Medical Student Research Fellowship, Yale University School of Medicine We would like to thank Mike Anzalone of Studiocode for development and aid with the iCODA application We would like to thank Dr. John Forrest &amp; associates at the YSM Office of Student Research For questions, please contact lucas.butler@yale.edu </li></ol>