Original Publication
Open Access

Rapid Cycle Deliberate Practice Pediatric Simulation Scenarios

Published: June 11, 2015 | 10.15766/mep_2374-8265.10134

Included in this publication:

  • Instructor's Guide.docx
  • PEA RCDP Scenario.docx
  • PEA RCDP Flowsheet.pdf
  • PEA RCDP Computer Operations.docx
  • PEA RCDP Program.scj
  • VT RCDP Scenario.docx
  • VT RCDP Flowsheet.pdf
  • VT RCDP Computer Operations.docx
  • VT RCDP Program.scj
  • Labs and Temperatures.docx

To view all publication components, extract (i.e., unzip) them from the downloaded .zip file.


Editor's Note: This publication predates our implementation of the Educational Summary Report in 2016 and thus displays a different format than newer publications.

Abstract

Introduction: Rapid cycle deliberate practice (RCDP) provides progressively more challenging simulation rounds in rapid repetition, with brief, usually directive expert feedback interspersed throughout the session. This is in contrast to traditional debriefing, which typically focuses on learning during debriefing after the scenario and most commonly seeks to uncover learners’ frames through advocacy-inquiry debriefing but does not provide the opportunity for repetitive practice. Methods: This curriculum is based on American Heart Association guidelines for pediatric resuscitation in two key algorithms, pulseless electrical activity and ventricular tachycardia. The curriculum provides two comprehensive RCDP pediatric resuscitation scenario sequences, as well as programs, operator instructions, and instructor guide. Using high-fidelity mannequins, learner teams of three to six residents participate in five or more progressively more difficult scenarios with directed instructor feedback and deliberate practice of resuscitation skills. The scenarios follow a sequence allowing the team to repetitively restart rounds of progressive difficulty, practicing the early stages of resuscitation and gradually incorporating more complicated components with each round. RCDP feedback is typically more directive and less reflective than traditional debriefing in order to allow the team to rapidly improve on key performance parameters based on established guidelines. When a round’s objectives have been met, the instructor may choose to do a partial stop and restart if there is a brief correction that needs to be made, do a full stop if a team mistake requires additional discussion, or advance to the next round. Results: We have taught these scenarios during a half-day dedicated to simulation for pediatric and emergency medicine residents during their pediatric emergency medicine rotation. At this time, we have taught 46 teams with three to six residents per team. Learners have expressed a high degree of satisfaction with the RCDP teaching methodology. Discussion: The scenarios could also be used for other trainees or resuscitation teams with similar levels of expertise or could be modified for teams with more or less experience. We have also begun teaching with interprofessional teams of residents and nurses. Currently, we are conducting a randomized controlled trial comparing these RCDP scenarios with traditional scenarios.


Educational Objectives

By the end of this module, learners will be able to:

  1. Perform effectively as a team leader or team member during resuscitation of a pediatric patient with pulseless electrical activity or pulseless ventricular tachycardia.
  2. Perform effective, high-quality, team-based cardiopulmonary resuscitation.
  3. Appropriately perform key steps of resuscitation within commonly defined times and in correct order.
  4. Effectively provide immediate postarrest care.
  5. Demonstrate key team communication skills such as sharing mental models, closed-loop communication, and clear role definition.

Author Information

  • Cara Doughty, MD, MEd: Baylor College of Medicine
  • Thomas Welch-Horan, MD: Baylor College of Medicine
  • Deborah Hsu, MD, MEd: Baylor College of Medicine
  • Elaine Fielder, MD: Baylor College of Medicine
  • Faria Pereira, MD: Baylor College of Medicine
  • Kim Little-Wienert, MD: Baylor College of Medicine
  • Brent Kaziny, MD: Baylor College of Medicine
  • Julie McManemy, MD: Baylor College of Medicine
  • Daniel Lemke, MD: Baylor College of Medicine

Disclosures
None to report.

Funding/Support
None to report.



Citation

Doughty C, Welch-Horan T, Hsu D, et al. Rapid cycle deliberate practice pediatric simulation scenarios. MedEdPORTAL. 2015;11:10134. https://doi.org/10.15766/mep_2374-8265.10134