Board 106 - Program Innovations Abstract Development, Implementation and Evaluation of a Simulation Based Boot Camp for Fellows from Multiple Specialties - The Integrated Fellows Simulation Training Program (Submission #861)

Introduction/Background Simulation based boot camps have grown in popularity within teaching institutions over the last five years. The goals of these programs are to improve competence and clinical performance in new postgraduate medical trainees at the start of fellowship in an era of limited work hours and experience during residency training, increasing concerns for patient safety and the rapid growth of simulation programs within teaching institutions. Traditionally, these boot camps have been developed for a single discipline such as pediatric critical care, internal medicine or surgery.1-5 They can be limited to specialties with high volumes of trainees given the time, resources and expense of developing an intensive simulation training program. Additionally, at large institutions like ours, with over 23 fellowship programs, it can be a challenge to provide the space, equipment, and time needed to implement simulation based boot camps during the month of July when new trainees arrive. In order to meet this challenge, we found a need to provide simulation based boot camps applicable to multiple specialties for improved efficiency and education for all postgraduate pediatric trainees. Methods The objectives were to develop, implement, and evaluate the efficacy of a one day simulation based boot camp for pediatric, medical and surgical trainees from multiple specialties. An experienced group of simulation trained educators from three diverse specialties (Pediatric Emergency Medicine, Pediatric Critical Care Medicine and Neonatal Intensive Care Medicine) gathered to discuss goals and objectives for a simulation based boot camp for all pediatric medical and surgical trainees. A formal needs assessment was conducted via a survey with program directors from all pediatric subspecialties to identify educational gaps. Curricular objectives were made based on results of the survey and identification of common patient safety and educational goals for any pediatric medical and surgical trainee - basic pediatric resuscitation skills (airway management, CPR and defibrillation, code cart familiarity and emergency access), effective teamwork and communication including crisis resource management and difficult conversations (delivery of bad news and disclosure of medical errors). Detailed course documents were developed including didactics, skills station objectives, high fidelity manikin and standardized patient scenarios, performance checklists and scripted debriefs. Instructors, including both physicians, nursing and respiratory therapists, were trained in simulation based methodologies and regularly teach within our simulation program. In order to create true multi disciplinary training opportunities, new and experienced nurses, respiratory therapists and pharmacists were invited to participate as learners with the fellow trainees. The Integrated Fellows Simulation-based Training Course (IFST) has been implemented for the last three years during the month of July. Since then, postgraduate fellowship trainees from multiple subspecialties have attended including pediatric surgery, pediatric otolaryngology, pediatric neurosurgery, rheumatology, endocrinology, pediatric hospital medicine, pediatric critical care and pediatric emergency medicine. Average scores for course evaluations on a 5-point Likert scale (1 strongly disagree to 5 strongly agree) have shown a high degree of satisfaction. Average ratings for "I plan to apply what I learned here to my clinical practice", "I would recommend this course to my colleagues" and "I feel that this course has improved my ability to care for my patients" were 4.75, 4.66, and 4.66 respectively. Average scores for "I feel that this course has improved communication skills and patient safety" were 4.69 and 4.71. Conclusion A simulation based boot camp for a diverse group of postgraduate learners can be developed and implemented with a high level of learner satisfaction. Combined simulation based boot camps can effectively provide valuable education to trainees who might not otherwise have this opportunity, due to a lack of resources or sufficient numbers to implement specialty specific programs. Future evaluation will look at six month follow-ups on skill utilization and retention. References 1. Esterl RM Jr, Henzi DL, Cohn SM. Senior medical student "boot camp": Can result in increased self-confidence before starting surgery internships. Curr Surg. 2006;63:264-268. 2. Parent RJ, Plerhoples TA, Long EE, et al. Early, intermediate, and late effects of a surgical skills "boot camp" on an objective structured assessment of technical skills: A randomized controlled study. J Am Coll Surg. 2010;210:984-989. 3. Fernandez GL, Page DW, Coe NP, et al. Boot cAMP: Educational outcomes after 4 successive years of preparatory simulation based training at onset of internship. J Surg Educ. 2012;69:242-248. 4. Cohen ER, Barsuk JH, Moazed F, Caprio T, Didwania A, McGaghie WC, Wayne DB. Making July Safer. Acad Med. 2013 Feb;88(2):233-9. doi: 10.1097/ACM.0b013e31827bfc0a. 5. Nishisaki A, Hales R, Biagas K, Cheifetz I, Corriveau C, Garber N, Hunt E, Jarrah R, McCloskey J, Morrison W, Nelson K, Niles D, Smith S, Thomas S, Tuttle S, Helfaer M, Nadkarni V. A multi-institutional high fidelity simulation "boot camp" orientation and training program for first year pediatric critical care medicine fellows. Pediatr Crit Care Med. 2009 Mar;10(2):157-62. doi: 0.1097/PCC.0b013e3181956d29. Disclosures Laerdal Foundation for Acute Medicine Cord Blood Registry- non simulation related.