Fostering self-determination of bedside providers to promote active participation in rapid response events

Figures & data

Table 1. Self-determination theory as a conceptual framework to guide the development and implementation of the program.

Self-determination theory components	Why: needs assessment	How: program development and implementation	What: program evaluation
Autonomy	Desire to maintain certain control over care	Highlight opportunities and ways to maintain control over patient’s care during didactic session Encourage exercising autonomy during group case discussions and simulations	Impact on participant perceptions of autonomous patient care and active engagement in activities that allowed for practice of autonomy
Competence	Desire to gain more knowledge and skills	Allow hands-on practice of RR knowledge and skills within a safe learning environment Provide immediate feedback and encouragement to assure individual’s competence	Improvement in clinical and systems knowledge and participants’ perceptions of RR skills
Relatedness	Desire to feel part of the team	Define clearly individual roles within the RR experience Highlight how individuals with variable levels of experience and disciplines can participate and contribute to the team effort Practice teamwork and functioning in a variety of roles	Participants’ engagement in activities that reinforced teamwork and satisfaction with potential of being productively involved with RRs in future

RR: Rapid response.

Figure 1. Process map of RRT workshop program development.

Table 2. Workshop educational activities.

Session	Content	Format	Duration
Interactive didactic	Understand structure of RR system, criteria, and process for RR activation Develop systematic approach to detect and manage common pediatric RR situations	Question and answers with informative slides and videos	30–45 min
Group cases	Practice early detection and response activation Develop communication skills useful for RR situations	Case vignettes practiced by participants grouped into four to six participants per group	1 h
Airway skill station	Learn utility of oxygen delivery devices and airway adjuncts Practice emergent respiratory support	Groups rotated through four skill stations; each group had four to six participants	30 min
Cardiac simulation	Recognize and manage acute cardiovascular instability		30 min
Neuro-respiratory simulation	Recognize and manage acute neurologic and respiratory instability		30 min
Challenging communication station	Learn strategies to navigate challenging or conflicting situations		30 min

RR: Rapid response.

Table 3. Change in rapid response knowledge and perceptions of self-determination components.

	Surgical advance practice providers			Pediatric residents
Domains	Pre	Post	p-Value	Pre	Post	p-Value
Systems knowledge (% accuracy)	75%	96%	p < 0.05*	93%	95%	p = 0.67
Clinical knowledge (% accuracy)	82%	95%	p < 0.05*	80%	95%	p < 0.05*
Autonomy (mean score)	2.05	4.3	p < 0.01*	2.2	4.5	p < 0.01*
Competence (mean score)	2	4.4	p < 0.01*	2.3	4.4	p < 0.01*
Relatedness (mean score)	2.5	4.5	p < 0.01*	2.8	4.5	p < 0.01*

*Significance level of p < 0.05.

Table 4. Program evaluation results (5-point-Likert scale).

Items	Mean score	Standard error	Standard deviation
Workshop organization	4.88	0.05	0.33
Clarity of information	4.83	0.07	0.45
Impact on detection and management of clinical decompensation	4.74	0.08	0.54
Benefit to communication skills	4.67	0.09	0.58
Utility for airway management	4.23	0.13	0.84
Improvement in team participation	4.79	0.07	0.47
Relevance to daily practice	4.74	0.08	0.5
Applicability of knowledge to daily practice	4.54	0.1	0.68
Feedback opportunities	4.46	0.12	0.75