What is the performance during repetitive immersive simulations of pediatric life-threatening events over one year? A randomized control trial of a 6-week vs 6-month interval.

Daniel Aiham GHAZALI, Emmanuelle FOURNIER, Cyril BREQUE, Stephanie RAGOT, Denis ORIOT



Objective: Analysis of performance evolution during repetitive immersive simulations over one year.

Methods: Single-center RCT including 48 participants randomized in 12 multidisciplinary teams (MDTs) of French EMS (including four members: physician/resident/nurse/ambulance driver). In the experimental group, six MDTs were exposed to nine different scenarios of infant shock in high-fidelity simulation over one year. In the control group, six MDTs had three scenarios common to those with the experimental group scenarios (initial, intermediate after six months and final after one year). Technical performance was assessed by the intra-osseous (IO) access performance scale and the Team Average Performance Assessment Scale (TAPAS) and non-technical performance by the Behavioral Assessment Tool (BAT) for leaders and the Clinical Teamwork Scale (CTS). Evolution of performance scores over time and comparison between the two groups during the common simulations were analyzed and carried out.

Results: Performance scores significantly increased over time in the experimental group (p=0.04 for TAPAS, p=0.03 for IO and BAT, p=0.007 for CTS). There was a significant difference between groups for IO during the intermediate session (p=0.03). All scores were higher in the experimental group during the final session (p=0.01 for TAPAS and IO, p=0.02 for BAT, and p=0.03 for CTS). During the 9th session of the experimental group, BAT was >60/100 and CTS >50/100 with a strong correlation between BAT and CTS (r2=0.92).

Conclusions: Simulation-based training should be repeated more than three times a year. Our results favored repetition of a low-volume high-stake situation every six weeks to improve all performance scores.

Palabras Clave

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