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Examining the Effect of a Scripted Debriefing on Resuscitation Performance in Pediatrics

Not Applicable
Completed
Conditions
Pediatric Cardiac Arrest (Simulated)
Interventions
Other: Debriefing Script
Other: High Physical Realism Simulation
Registration Number
NCT01682629
Lead Sponsor
KidSIM Simulation Program
Brief Summary

The investigative team's purpose for conducting this research is to improve effective and efficient translation and implementation of evidence based advanced life support practice to providers of care for children. This specific project aims to accomplish 2 major goals. The investigators aim to evaluate the utility of a debriefing script specifically designed to facilitate debriefing when used by novice Pediatric Advanced Life Support instructors during low and high realism simulation-based learning. Secondly, the investigators hope to evaluate the effectiveness of high realism simulation vs. low realism simulation in achieving PALS-based educational outcomes, such as knowledge and skill acquisition.

The investigators hypothesize that SCRIPTED debriefing by novice instructors following low and high fidelity simulation-based learning will :

1. Improve the cognitive performance and knowledge of multidisciplinary team members as assessed by a cognitive performance tool and multiple choice testing compared with more traditional, NON-SCRIPTED debriefing;

2. Improve the behavioural, teamwork and communication skills of multidisciplinary team members as assessed by a validated assessment tool compared with more traditional, NON-SCRIPTED debriefing;

The investigators hypothesize that HIGH REALISM simulation-based learning will:

1. Improve the cognitive performance and knowledge of multidisciplinary team members as assessed by a cognitive performance tool and multiple choice testing compared with more traditional, LOW REALISM simulation;

2. Improve the behavioural, teamwork and communication skills of multidisciplinary team members as assessed by a validated assessment tool compared with more traditional, LOW REALISM simulation;

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
443
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
FACTORIAL
Arm && Interventions
GroupInterventionDescription
Scripted debriefing, Low RealismDebriefing ScriptIn this arm, novice instructors were provided the scenario learning objectives WITH A DEBRIEFING SCRIPT, and asked to observe the simulation and conduct a 20 minute debriefing USING THE SCRIPT. The lo realism group had the simulator with the compressor turned on, thus eliminating the functionality of physical findings.
non-Scripted Debriefing, High Realism SimulationHigh Physical Realism SimulationIn this arm, novice instructors were provided the scenario learning objectives WITHOUT A DEBRIEFING SCRIPT, and asked to observe the simulation and conduct a 20 minute debriefing WITHOUT USING THE SCRIPT. The hi realism group had the simulator with the compressor turned on, thus activating the functionality of physical findings.
Scripted Debriefing, High Realism SimulationDebriefing ScriptIn this arm, novice instructors were provided the scenario learning objectives WITH A DEBRIEFING SCRIPT, and asked to observe the simulation and conduct a 20 minute debriefing USING THE SCRIPT. The hi realism group had the simulator with the compressor turned on, thus activating the functionality of physical findings.
Scripted Debriefing, High Realism SimulationHigh Physical Realism SimulationIn this arm, novice instructors were provided the scenario learning objectives WITH A DEBRIEFING SCRIPT, and asked to observe the simulation and conduct a 20 minute debriefing USING THE SCRIPT. The hi realism group had the simulator with the compressor turned on, thus activating the functionality of physical findings.
Primary Outcome Measures
NameTimeMethod
Behavioural Assessment Tool Score (Percentage 0-100%)Baseline of one hour (post debreifing) - note: reporting change in timeframe for all 3 outcome measures

Behavioral Assessment Tool The Behavioral Assessment Tool (BAT) was used to assess the team leader's crisis resource management skills during the pre and post-simulation scenarios. Each behavior is rated on a five-point Likert scale, where a score of one represents poor behavioral performance in the category and a score of five reflects excellent performance. Each behavior is supplement by descriptive anchors for poor (1), average (3) and excellent performance (5). Previous work done by LeFlore et al has focused on establishing reliability and validity of the tool in varying contexts. In a study of nurse practitioner students, data demonstrated a Cronbach's alpha of 0.97 with an intraclass correlation coefficient of 0.84 (p\<0.001). In a different study assessing alternative educational models for interdisciplinary student teams, the BAT was used to assess behavioral performance and the Cronbach's alpha was 0.956.

Secondary Outcome Measures
NameTimeMethod
Clinical Performance Tool Score (Percentage 0-100%)Baseline of one hour (post debreifing) - note: reporting change in timeframe for all 3 outcome measures

The Clinical Performance Tool, with 21 individual items, designed for evaluation of Pediatric Advanced Life Support scenarios, was utilized to assess clinical performance of the team. A total score (maximum 42 points) was converted into a percentage (0-100%) for analysis.

Multiple Choice Test (Knowledge)Baseline of one hour (post debreifing) - note: reporting change in timeframe for all 3 outcome measures

For the 20 question test, 15 questions designed to test medical knowledge were chosen from the existing American Heart Association Pediatric Advanced Life Support (PALS) question bank that have undergone rigorous validation, while 5 new questions were developed to assess knowledge of crisis resource management principles. As the study design required a "Test A and Test B", stems for the same questions were modified slightly (eg. different age of patient, different vital signs, different history) between the two different tests, but overall content and purpose of questions were structured to be the same.

Trial Locations

Locations (1)

BC Children's Hospital

🇨🇦

Vancouver, British Columbia, Canada

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