Dataset Information

Pediatric Pulseless Ventricular Tachycardia: A Simulation Scenario for Fellows, Residents, Medical Students, and Advanced Practitioners.

ABSTRACT:

Introduction

Pulseless ventricular tachycardia is an uncommon presentation to the pediatric emergency department (ED) or the pediatric ICU (PICU); however, if unrecognized or inappropriately treated, it can lead to significant morbidity and mortality. This resource was created to simulate a high-acuity and low-frequency event targeting PICU fellows, pediatric emergency medicine fellows, pediatric residents, ED residents, medical students, and advanced nursing providers.

Methods

This scenario details the case of a 12-year-old boy with a history of heart transplant who presents with the chief complaint of dizziness. He initially has multiple premature ventricular contractions and then progresses to pulseless ventricular tachycardia due to acute rejection. This simulation may be performed in a simulation lab or in situ in the ICU or ED. Necessary personnel include a simulation technician, instructors, and a nurse. A code cart and defibrillator with hands-free pads appropriate for the mannequin are needed supplies. Critical actions include cardiopulmonary resuscitation, defibrillation with three shocks, and administration of anti-arrhythmic. At the end of the scenario, a formal debriefing and learner assessment with structured feedback are performed.

Results

Approximately 110 learners have completed this module during 18 separate sessions. Written evaluation from participants (n = 94) using a Likert scale (1 = not at all, 4 = to a great extent) shows that the objectives of the simulation are met to a great extent, with an average score of 3.8.

Discussion

In conclusion, this resource advances learner knowledge and comfort when managing a pediatric patient with pulseless ventricular tachycardia, reviews appropriate management, and helps identify knowledge deficits in the management of these patients.

SUBMITTER: Cashen K

PROVIDER: S-EPMC6464469 | biostudies-literature | 2016 Jun

REPOSITORIES: biostudies-literature

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Publications

Pediatric Pulseless Ventricular Tachycardia: A Simulation Scenario for Fellows, Residents, Medical Students, and Advanced Practitioners.

Cashen Katherine K Petersen Tara T

MedEdPORTAL : the journal of teaching and learning resources 20160603

<h4>Introduction</h4>Pulseless ventricular tachycardia is an uncommon presentation to the pediatric emergency department (ED) or the pediatric ICU (PICU); however, if unrecognized or inappropriately treated, it can lead to significant morbidity and mortality. This resource was created to simulate a high-acuity and low-frequency event targeting PICU fellows, pediatric emergency medicine fellows, pediatric residents, ED residents, medical students, and advanced nursing providers.<h4>Methods</h4>Th ...[more]

PMID: 31008187

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Project description:BackgroundResidents in surgical specialties face a steep hierarchy when managing medical crises. Hierarchy can negatively impact patient safety when team members are reluctant to speak up. Yet, simulation has scarcely been previously utilized to qualitatively explore the way residents in surgical specialities navigate this challenge. The study aimed to explore the experiences of residents in one surgical specialty, obstetrics and gynecology (Ob/Gyn), when challenging hierarchy, with the goal of informing future interventions to optimize resident learning and patient safety.MethodsEight 3rd- and 4th-year Ob/Gyn residents participated in a simulation scenario in which their supervising physician made an erroneous medical decision that jeopardized the wellbeing of the labouring mother and her foetus. Residents participated in 30-45 min semi-structured interviews that explored their approach to managing this scenario. Transcribed interviews were analysed using qualitative thematic inquiry by three research team members, finalizing the identified themes once consensus was reached.ResultsStudy results show that the simulated scenario did create an experience of hierarchy that challenged residents. In response, residents adopted three distinct communication strategies while confronting hierarchy: (1) messaging - a mere reporting of existing clinical information; (2) interpretive - a deliberate construction of clinical facts aimed at swaying supervising physician's clinical decision; and (3) advocative - a readiness to confront the staff physician's clinical decision. Furthermore, residents utilized coping mechanisms to mitigate challenges related to confronting hierarchy, namely deflecting responsibility, diminishing urgency, and drafting allies. Both these communication strategies and coping mechanisms shaped their practice when challenging hierarchy to preserve patient safety.ConclusionsUnderstanding the complex processes in which residents engage when confronting hierarchy can serve to inform the development and study of curricular innovations. Informed by these processes, we must move beyond solely teaching residents to speak up and consider a broader curriculum that targets not only residents but also faculty physicians and the learning environment within the organization.

Dataset Information

Pediatric Pulseless Ventricular Tachycardia: A Simulation Scenario for Fellows, Residents, Medical Students, and Advanced Practitioners.

Introduction

Methods

Results

Discussion

Publications

Pediatric Pulseless Ventricular Tachycardia: A Simulation Scenario for Fellows, Residents, Medical Students, and Advanced Practitioners.

Similar Datasets

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