A Multi-Institutional Simulation Boot Camp for Pediatric Cardiac Critical Care Nurse Practitioners

作者：Brown Kristen M^*; Mudd Shawna S; Hunt Elizabeth A; Perretta Julianne S; Shilkofski Nicole A; Diddle J Wesley; Yurasek Gregory; Bembea Melania; Duval Arnould Jordan; Nelson McMillan Kristen

来源：Pediatric Critical Care Medicine, 2018, 19(6): 564-571.

DOI：10.1097/PCC.0000000000001532

• boot camp
• congenital heart disease
• low cardiac output
• pediatric nurse practitioner
• rapid cycle deliberate practice
• simulation

Objectives: Assess the effect of a simulation boot camp on the ability of pediatric nurse practitioners to identify and treat a low cardiac output state in postoperative patients with congenital heart disease. Additionally, assess the pediatric nurse practitioners' confidence and satisfaction with simulation training.
Design: Prospective pre/post interventional pilot study.
Setting: University simulation center.
Subjects: Thirty acute care pediatric nurse practitioners from 13 academic medical centers in North America.
Interventions: We conducted an expert opinion survey to guide curriculum development. The curriculum included didactic sessions, case studies, and high-fidelity simulation, based on high-complexity cases, congenital heart disease benchmark procedures, and a mix of lesion-specific postoperative complications. To cover multiple, high-complexity cases, we implemented Rapid Cycle Deliberate Practice method of teaching for selected simulation scenarios using an expert driven checklist.
Measurements and Main Results: Knowledge was assessed with a pre-/posttest format (maximum score, 100%). A paired-sample t test showed a statistically significant increase in the posttest scores (mean [sd], pre test, 36.8% [14.3%] vs post test, 56.0% [15.8%]; p < 0.001). Time to recognize and treat an acute deterioration was evaluated through the use of selected high-fidelity simulation. Median time improved overall time to task across these scenarios. There was a significant increase in the proportion of clinically time-sensitive tasks completed within 5 minutes (pre, 60% [30/50] vs post, 86% [43/50]; p = 0.003] Confidence and satisfaction were evaluated with a validated tool (Student Satisfaction and Self-Confidence in Learning). Using a five-point Likert scale, the participants reported a high level of satisfaction (4.70.30) and performance confidence (4.8 +/- 0.31) with the simulation experience.
Conclusions: Although simulation boot camps have been used effectively for training physicians and educating critical care providers, this was a novel approach to educating pediatric nurse practitioners from multiple academic centers. The course improved overall knowledge, and the pediatric nurse practitioners reported satisfaction and confidence in the simulation experience.

• 出版日期2018-6