A Multi-Institutional Simulation Boot Camp for Pediatric Cardiac Critical Care Nurse Practitioners*. Issue 6 (June 2018)

• Record Type: Journal Article
• Authors: Brown, Kristen M.; Mudd, Shawna S.; Hunt, Elizabeth A.; Perretta, Julianne S.; Shilkofski, Nicole A.; Diddle, J. Wesley; Yurasek, Gregory; Bembea, Melania; Duval-Arnould, Jordan; Nelson McMillan, Kristen
• Is Part Of: Pediatric critical care medicine. Volume 19:Issue 6(2018)
• Publication Date: 2018-06
• Subjects: boot camp -- congenital heart disease -- low cardiac output -- pediatric nurse practitioner -- rapid cycle deliberate practice -- simulation; Pediatric intensive care -- Periodicals; Pediatric emergencies -- Periodicals; 618.05
• DOI: 10.1097/PCC.0000000000001532
• Languages: English
• ISSNs: 1529-7535

Abstract

Abstract : Objectives: Assess the effect of a simulation "boot camp" on the ability of pediatric nurse practitioners to identify and treat a low cardiac output state in postoperative patients with congenital heart disease. Additionally, assess the pediatric nurse practitioners' confidence and satisfaction with simulation training. Design: Prospective pre/post interventional pilot study. Setting: University simulation center. Subjects: Thirty acute care pediatric nurse practitioners from 13 academic medical centers in North America. Interventions: We conducted an expert opinion survey to guide curriculum development. The curriculum included didactic sessions, case studies, and high-fidelity simulation, based on high-complexity cases, congenital heart disease benchmark procedures, and a mix of lesion-specific postoperative complications. To cover multiple, high-complexity cases, we implemented Rapid Cycle Deliberate Practice method of teaching for selected simulation scenarios using an expert driven checklist. Measurements and Main Results: Knowledge was assessed with a pre-/posttest format (maximum score, 100%). A paired-sample t test showed a statistically significant increase in the posttest scores (mean [SD], pre test, 36.8% [14.3%] vs post test, 56.0% [15.8%]; p < 0.001). Time to recognize and treat an acute deterioration was evaluated through the use of selected high-fidelity simulation. Median time improved overall "time to task" across these scenarios. There was a significant increase in the proportion of clinically time-sensitive tasks completed within 5 minutes (pre, 60% [30/50] vs post, 86% [43/50]; p = 0.003] Confidence and satisfaction were evaluated with a validated tool ("Student Satisfaction and Self-Confidence in Learning"). Using a five-point Likert scale, the participants reported a high level of satisfaction (4.7 ± 0.30) and performance confidence (4.8 ± 0.31) with the simulation experience. Conclusions: Although simulation boot camps have been used effectively for training physicians and educating critical care providers, this was a novel approach to educating pediatric nurse practitioners from multiple academic centers. The course improved overall knowledge, and the pediatric nurse practitioners reported satisfaction and confidence in the simulation experience.