Training of Pediatric Critical Care Providers in Developing Countriesin Evidence Based Medicine Utilizing Remote Simulation Sessions

摘要

Background. Remote simulation training provides a uniqueopportunity to captivate providers despite language, distance, and culturalbarriers. Previously we developed a novel electronic decision support androunding tool, the Checklist for Early Recognition and Treatment of AcuteIllness in Pediatrics (CERTAINp). This study was conducted to determine thefeasibility and impact of remote simulation training of international PICUproviders using CERTAINp. Methods. We conductedtrain-the-trainer sessions in 7 hospitals based in 5 countries (China, Congo,Croatia, India, and Turkey) between 11/2015 and 11/2016. Providers first tookpart in a base line simulation session to assess their clinical performance.They had structured hands-on training using CERTAINp, which was done remotelyusing video conference with recording capabilities. Performance in PICU“admission” and “rounding” scenarios was assessed by their adherence to standardof care guidelines using CERTAINp. After this training, the providers werere-evaluated for performance using a validated instrument by 2 independenttrained reviewers. Results. A total of 7 hospitals completedboth baseline and post simulation sessions. We observed improved critical task(total 14) completion in the admission scenarios where pre training taskcompletion was 8.2 ± 2.6, while after remote training was 11.2 ± 1.8,P = .01. In rounding scenarios, compliance to standard ofcare guidelines improved overall from 45% to 95% (P < .01).Conclusion. We observed an improvement in compliance formeasures determined as best practice guidelines in simulation rounding andoverall improvement in critical tasks for simulated admission cases after remotetraining.