Assistant Professor, Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Texas Southwestern Medical Center.
Assistant Professor, Division of Pediatric Emergency Medicine, Departments of Pediatrics and Emergency Medicine, University of Connecticut School of Medicine and Connecticut Children's Medical Center; Director of Simulation, University of Connecticut School of Medicine.
MedEdPORTAL. 2022 Jan 21;18:11214. doi: 10.15766/mep_2374-8265.11214. eCollection 2022.
During COVID-19 surges, medical trainees may perform patient care outside typical clinical responsibilities. While respiratory failure in pediatric patients secondary to COVID-19 is rare, it is critical that providers can effectively care for these children while protecting the health care team. Simulation is an important tool for giving learners a safe environment in which to learn and practice these new skills.
In this simulation, learners provided care to a 13-year-old male with obesity, COVID-19 pneumonia, status asthmaticus, and respiratory failure. Target learners were pediatric emergency medicine fellows and emergency medicine residents. Providers were expected to identify the signs and symptoms of status asthmaticus, pneumonia, and respiratory failure and demonstrate appropriate evaluation and management while minimizing COVID-19 exposure. Participants completed a postsimulation survey on their satisfaction and confidence in performing the objectives.
Twenty-eight PGY 1-PGY 6 learners participated in this simulation. The postsimulation survey showed that most learners felt the simulation was effective in teaching the evaluation and management of respiratory failure due to COVID-19 ( = 5.0; 95% CI, 4.9-5.0) and was relevant to their work ( = 5.0; 95% CI, 5.0-5.0).
Learners felt that the case was effective in teaching the skills needed to care for a child with COVID-19 pneumonia, status asthmaticus, and respiratory failure. Future directions include updating the case with new COVID-19 knowledge and personal protective equipment practices gained over time, using hybrid telesimulation to increase learners' exposure to the case, and adapting the case for other health care providers.
在 COVID-19 疫情高峰期，医学实习生可能会承担超出常规临床职责的患者护理工作。虽然 COVID-19 导致的儿科患者呼吸衰竭较为罕见，但重要的是医护人员能够在保护医护团队健康的同时，有效地为这些患儿提供护理。模拟是为学习者提供安全学习和实践新技能环境的重要工具。
在本次模拟中，学习者为一名患有肥胖症、COVID-19 肺炎、哮喘持续状态和呼吸衰竭的 13 岁男性患者提供了护理。目标学习者为儿科急诊医学研究员和急诊医学住院医师。要求提供者识别出哮喘持续状态、肺炎和呼吸衰竭的迹象和症状，并在尽量减少 COVID-19 暴露的情况下，展示出适当的评估和管理方法。参与者在模拟后完成了一份关于他们在完成目标方面的满意度和信心的调查。
共有 28 名 PGY1-PGY6 级的学习者参加了本次模拟。模拟后调查显示，大多数学习者认为该模拟在教授 COVID-19 导致的呼吸衰竭的评估和管理方面非常有效（ = 5.0；95%CI，4.9-5.0），并且与他们的工作相关（ = 5.0；95%CI，5.0-5.0）。
学习者认为该病例在教授照顾患有 COVID-19 肺炎、哮喘持续状态和呼吸衰竭的儿童所需的技能方面非常有效。未来的方向包括随着时间的推移更新病例以纳入新的 COVID-19 知识和个人防护设备实践，使用混合远程模拟增加学习者对该病例的接触，以及为其他医护人员改编该病例。
