Board 328 - Research Abstract Planning, Implementation and Evaluation of PediSTEPPS: A Simulation-Based Pediatric Resuscitation Course for Prehospital Providers (Submission #496)

Introduction/Background Prehospital providers rarely manage critically ill pediatric patients.1-3 Ongoing pediatric resuscitation education is critical to maintaining provider knowledge and skills. However, numerous barriers limit prehospital providers access to pediatric continuing education.2 Simulation-based education is ideally suited to resuscitation education and it has been used to identify performance deficiencies in paramedics for planning follow-up educational interventions.4,5 Methods A consensus group of experts in simulation, medical education, pediatric emergency medicine (PEM), prehospital pediatrics and emergency medical services (EMS) convened to develop goals and objectives for the course, focused on unique aspects of pediatric assessment, management, hands-on skills and teamwork in high-fidelity resuscitation scenarios. Detailed course materials were developed including lectures, skills station guides, high-fidelity scenario goals and objectives, manikin programs, scripted debriefings, debriefing checklists and confederate roles. Planned evaluations included pre and post-tests, self-efficacy checklists and a course satisfaction survey. All course materials were congruent with the prehospital protocols and scope of practice for the Emergency Medical Technician (EMT) - basic and paramedic provider levels of the City of Houston Fire Department (HFD) EMS. HFD EMS and PEM instructors were trained to teach PediSTEPPS. After initial curriculum development and instructor training, the curriculum was trialed with HFD EMS providers and then modified based on their feedback and the feedback of the HFD EMS medical directors. Results To date, PediSTEPPS has been taught for 8 months to a total of 209 participants. EMT-B pre and post-test scores increased from 64.4 % (95% CI: 62.3-66.5%) to 75.2% (95% CI: 73.6-76.9%) (p<0.001). They also increased from 68.3% (95% CI: 65.9-70.7%) to 80.2% (78.2-82.1%) for EMT-Ps (p<0.001). On a 5 point Likert scale (1 = strongly disagree; 5 = strongly agree), the mean participant ratings were as follows: “Simulation is the appropriate methodology to teach this material,” mean = 4.70 (range 2-5); “The course was appropriate for my level of learning,” mean = 4.64 (range 1-5); “This course has improved my clinical knowledge,” mean = 4.70 (range 3-5); and “I plan to apply what I learned here to my clinical practice,” mean 4.81 (range 3-5). The lowest satisfaction was with “The simulation center environment is realistic to my clinical environment,” mean = 4.28 (range 1-5). Conclusion Multidisciplinary collaboration between simulation-based medical educators, PEM physicians and EMS providers is feasible. PediSTEPPS significantly improved provider knowledge scores immediately after completion of the course for both EMT-B and EMT-P providers. Implementing a simulation-based pediatric resuscitation course with consideration of EMT-Basic and paramedic level providers scope of practice is associated with high learner satisfaction. Simulating a realistic prehospital environment remains challenging. Future work will evaluate knowledge and skills retention, self-efficacy and clinical performance. References 1. Gausche M, Henderson DP, Seidel JS. Vital Signs as Part of the Prehospital Assessment of the Pediatric Patient: A Survey of Paramedics. Annals of Emergency Medicine. 1990; 19(2): 173-178. 2. Glaeser PW, Linzer J, Tunik MG, Henderson DP, Ball J. Survey of Nationally Registered Emergency Medical Services Providers: Pediatric Education. Annals of Emergency Medicine. 2000; 36(1): 33-38. 3. Graham CJ, Stuemky J, Lera TA. Emergency Medical Services Preparedness for Pediatric Emergencies. Pediatric Emergency Care. 1993; 9(6): 329-331. 4. Miller DR, Kalinowski EJ, Wood D. Pediatric continuing education for EMTs: Recommendations for content, method, and frequency. Pediatric Emergency Care 2004; 20(4): 269-272. 5. Lammers RL, Byrwa MJ, Fales WD, Hale RA. Simulation-based assessment of paramedic resuscitation skills. Prehospital Emergency Care 2009;13:345-356. Disclosures Laerdal Foundation for Acute Medicine Cord Blood Registry- non simulation related.