P3.R349: Translational Learning: Human Factors in Simulation Training for Pediatric Emergency Medicine Fellows

Background: Pediatric training curriculums frequently contain simulation-based activities. Encounters with critically ill children are high-risk, low frequency events amenable to simulation-based education. This is particularly true for Pediatric Emergency Medicine (PEM), where procedural skill and resuscitation competencies are foundational. Currently existing simulation content in this area consists largely of difficult medical cases, infrequent medical cases, or tools to disseminate such cases across varying venues. Seemingly less present is the inclusion of human factors development, which encompasses critical aspects underpinning the ability to achieve desired learning outcomes. Human factors training has high translational ability given that interpersonal development is an inherent component in a fellowship training path, as are complex interprofessional interactions required to function clinically as a high achieving pediatric subspecialist.

Methods: A rotating curriculum was developed through use of a value proposition model. This model identified the simulation curriculum as the “product and service” and the “customers” as PEM Fellows, instructors, and subspecialty expectations at large (Figure 1). The curriculum was leveraged as a tool to provide pain relievers and gain creators to satisfy needs identified in the customer list. The following 4 topics emerged as guiding principles: emotional intelligence, wellness, continuous development, and camaraderie. A competency framework was built to host all desired elements and a table was generated to function as a plug-and-play for varying scenarios throughout the year (Figure 2). Fellows were surveyed by the simulation center after each simulation.

Results: The competency framework contained three core domains: PEM content, relational goals, and environmental factors. These domains fed into a continuous development target with PEM readiness objectives. The core domains had significant overlap, which afforded ease of incorporating varying degrees of human factors training into individual scenarios, without the burden of attempting to achieve all within a singular session. Incorporation of these principles into a standing curriculum maximized opportunity to capture, catalog, and debrief critical moments of development in a safe learning environment, while providing space for fellows to visualize how these concepts translate to practice through mental rehearsal and group discussion. Gains in psychological safety were seen in post session fellow surveys during the first year where 100% reported feeling safe to ask questions and make mistakes, with 88% categorizing as strongly agree. 100% reporting feeling equipped for clinical practice based on the simulated learning experience, with 79% categorizing as strongly agree.

Conclusion: Incorporation of human factors into PEM simulation curriculum by way of diversified needs assessments and a competency framework lends itself to capture, catalog, and debrief critical moments necessary to achieve outcomes that are holistic and ripe for translation to clinical practice. The involvement of participants as stakeholders and interweaving of relational objectives was associated with high scores in psychological safety and feeling confident to perform clinically.