Connecticut — Targeted Issue

Author(s)/Presenter(s)

Mark X Cicero MD, Janette Baird PhD , Kathleen Adelgais, MD MPH, Linda Brown, MD MSCE, Marc Auerbach MD, MSci

Abstract/Description

SimBox is a free-to-use, all-in-one resource for simulation education. Strengths of the program include resources for facilitators and debriefers, ease use and avoiding the need for costly simulation equipment.

Author(s)/Presenter(s)

Mark Cicero, Janette Baird, Kathleen Adelgais, Linda Brown, Marc Auerbach

Abstract/Description

Objective: SimBox simulations allow for high-frequency open-access health care education, overcoming cost and resource barriers. Prehospital paramedics and emergency medical technician (EMT) care for children infrequently. In this study, prehospital providers evaluated pediatric SimBox simulations.

Methods: This was a cross-sectional study of EMS professionals participating in a series of simulations conducted in a larger project assessing improvement of the quality of pediatric care in the prehospital setting. Participants were teams of two, which comprised a paramedic/paramedic, paramedic/EMT, or 2 EMTs. The simulations used facilitator resources, debriefing prompts, video depictions of patients and vital signs, and a low-fidelity manikin. Pediatric emergency care coordinators, EMS training officers, and/or emergency physicians facilitated simulations of seizure, sepsis with respiratory failure, and child abuse, followed by debriefings. Participants completed an online survey after the simulation and rated it in 4 domains: prebriefing, scenario content, debriefing, and overall. Ratings were trifold: "strongly agree," "somewhat agree," or "do not agree." Data were analyzed by case type, participant type, location, participant reaction to simulation elements, and the debriefing. Net Promoter Scores were calculated to assess participant endorsement of SimBox.

Results: There were 121 participants: 103 (87%) were paramedics, and 18 (13%) were EMTs. Participant agreement of simulation benefit for clinical practice was high, for example, "I am more confident in my ability to prioritize care and interventions" (98.4% strongly or somewhat agree), and 99.2% of participants agreed the postsimulation debriefing with facilitators "provided opportunities to self-reflect on my performance during simulation." Overall, 97.5% strongly or somewhat agreed that the simulations "improved my comfort in pediatric acute care." Net Promoter Score showed 65.3% were promoters of and 24% were passive about SimBox.

Conclusion: SimBox simulations are associated with improved self-efficacy of prehospital care providers for care of acutely ill or injured children. The majority promotes SimBox as a learning tool.

Keywords

simulation, SimBox, pediatric, ems

Author(s)/Presenter(s)

Mark X Cicero MD, Janette Baird PhD , Kathleen Adelgais, MD MPH, Linda Brown, MD MSCE, Marc Auerbach MD, Msci

Abstract/Description

Background: SimBox simulations allow for high-frequency open-access healthcare education, overcoming cost and resource barriers. Prehospital paramedics and Emergency Medical Technicians (EMTs) care for children infrequently. In this study, prehospital providers evaluated pediatric SimBox simulation.

Keywords

PECC, simulation

Author(s)/Presenter(s)

Julianne Cyr, Mark Cicero, MD, Amanda Perry, MEd, NRP

Abstract/Description

Brief updates on three Targeted Issues Grants focusing on PECCs

Keywords

PECC, pediatric emergency care coordinator

Author(s)/Presenter(s)

Mark Xavier Cicero, Linda Brown, Marc Auerbach, Janette Baird, Kathleen Adelgais

Abstract/Description

Background: Though family satisfaction with prehospital care is a surrogate for quality and patient outcomes, there are no tools available to measure family satisfaction.

Objective: To develop the EMS Family Assessment of Medical Interventions & Liaisons with the Young (FAMILY) instrument.

Methods: Components of family experiences with pediatric prehospital care were identified with a modified Delphi method. The expert panel included Emergency Medical Technicians, paramedics, family representatives, and EMS leaders from Colorado, Connecticut, and Rhode Island. An online survey was used to assess proposed questions from each of five candidate domains from national guidelines, including Safety, Communication, Family Presence, Cultural Awareness, Children with Special Healthcare Needs and Overall Satisfaction. Round-1 items were scored on a five-point Likert scale. Inclusion in the final instrument required 70% agreement ranking items as "include" or "definitely include." In Round-2, participants assessed proposed refinements. This resulted in FAMILY Version-1, with sections for family members and EMS care providers. EMSC Family Action Network (FAN) representatives evaluated the FAMILY, leading to Version-2. Suggestions from the national FAN about content, clarity, and whether the instrument captured their experiences with pediatric EMS care led to the final FAMILY version. Bilingual speakers translated the instrument into Spanish, while assessing the content for semantic, idiomatic, experiential, and conceptual equivalence between the English and Spanish versions.

Results: There were 22 experts in Round-1, and 20 continued into Round-2 .The Delphi process yielded 12 questions in six domains with 14 recommended modifications. Two questions were excluded. Five domains reached 70% agreement in Round-1. Cultural Awareness reached 75% agreement after Round-2. Six FAN representatives evaluated Version-1, leading to changes for clarity, content and cultural sensitivity. Seventeen FAN representatives evaluated Version-2 leading to additional refinement. The assessment of the equivalence between the English and Spanish survey versions resulted in changes in the Spanish language content for equivalent meaning.

Conclusion: A panel of EMS and family stakeholders successfully developed an instrument to assess family satisfaction with pediatric EMS care. Further validation is required in a large respondent population. Assessing family satisfaction with pediatric EMS encounters is an important step toward improving prehospital care.

Keywords

derivation; family; paramedics; pediatrics; satisfaction