Assistant Professor, Department of Pediatrics, Johns Hopkins University School of Medicine; Adjunct Faculty, Johns Hopkins University School of Education.
Associate Professor, Department of Pediatrics, and Associate Professor, Division of General Internal Medicine, Johns Hopkins University School of Medicine.
MedEdPORTAL. 2023 Jun 13;19:11318. doi: 10.15766/mep_2374-8265.11318. eCollection 2023.
Acute bronchiolitis is a viral infection infecting 90% of children under the age of 2 years, with approximately 200,000 deaths per year. The current standard of care remains largely respiratory support and prevention. Therefore, understanding how to assess and escalate respiratory supportive care is paramount for health care providers taking care of children.
We used a high-fidelity simulator to simulate an infant with progressing respiratory distress in the setting of acute bronchiolitis. The participants were pediatric clerkship medical students during their preclerkship educational exercises (PRECEDE). The students were asked to evaluate and treat the simulated patient. After debriefing, the students repeated the simulation. We assessed both performances via a weighted checklist specifically developed for this case to measure team performance. Students also completed an overall course evaluation.
Ninety out of 121 pediatric clerkship students were enrolled. Performance improved from 57% to 86% ( < .05). Donning appropriate personal protection equipment was the most missed item both pre- and postdebriefing. Overall, the course was well liked and received. Participants requested more simulation opportunities within PRECEDE as well as a summary document to reinforce learning.
Pediatric clerkship students improved their performance managing progressing respiratory distress due to acute bronchiolitis via a performance-based assessment tool with sound validity evidence. Improvements going forward include improving faculty diversity and offering more simulation opportunities.
急性细支气管炎是一种病毒性感染,影响 90%以下的 2 岁儿童,每年约有 20 万人死亡。目前的护理标准仍然主要是呼吸道支持和预防。因此,了解如何评估和升级呼吸支持护理对照顾儿童的医疗保健提供者至关重要。
我们使用高保真模拟器模拟患有急性细支气管炎的婴儿病情逐渐加重的呼吸窘迫。参与者是儿科实习医学生在他们的实习前教育练习(PRECEDE)期间。要求学生评估和治疗模拟患者。在汇报后,学生重复模拟。我们通过专门为此案例开发的加权检查表来评估这两个表现,以衡量团队表现。学生还完成了整体课程评估。
90 名 121 名儿科实习医学生参加了该研究。表现从 57%提高到 86%(<0.05)。戴适当的个人防护设备是课前和课后汇报中最容易遗漏的项目。总的来说,该课程很受欢迎。参与者要求在 PRECEDE 期间增加更多模拟机会以及一份总结文件以加强学习。
儿科实习医学生通过具有良好有效性证据的基于表现的评估工具提高了他们对急性细支气管炎引起的进展性呼吸窘迫的管理能力。未来的改进包括提高教师的多样性并提供更多的模拟机会。