Development and assessment of a pediatric emergency medicine simulation and skills rotation: meeting the demands of a large pediatric clerkship

Figures & data

Fig. 1.  Study design and curriculum outline.

Table 1 Comfort with pediatric emergency procedures and medical management

	Traditional curriculum n=48			PEM-SIM curriculum n=61
	Pre-test	Post-test	Δ	Pre-test	Post-test	Δ	Δ difference
Procedures
Splinting a fracture^a	1.69	2.94	+1.25	1.8	4.07	+2.27	+1.02*
Infant lumbar puncture^a	1.81	2.40	+0.59	1.92	3.31	+1.39	+0.8*
Abscess I&D^a	2.46	3.08	+0.62	2.79	3.98	+1.19	+0.57*
Laceration repair	2.42	2.94	+0.52	3.1	3.89	+0.79	+0.27
Endotracheal intubation	1.56	1.85	+0.29	1.89	2.28	+0.39	+0.1
PIV insertion	2.19	2.69	+0.50	2.59	3.2	+0.61	+0.11
Transurethral cath	2.67	3.04	+0.37	3.38	3.82	+0.44	+0.07
Medical management
Closed head injury^a	2.19	2.98	+0.79	2.00	3.57	+1.57	+0.78*
Neonatal fever^a	3.13	3.65	+0.52	2.74	4.02	+1.28	+0.76*
Altered mental status	2.08	2.77	+0.69	1.90	3.30	+1.40	+0.71*
Vaso-occlusive crisis	2.25	2.69	+0.44	2.34	3.46	+1.12	+0.68*
Septic shock	2.13	2.67	+0.54	1.97	3.05	+1.08	+0.54*
Acute abdominal pain	2.94	3.71	+0.77	2.61	3.82	+1.21	+0.44*
Bronchiolitis	3.06	3.67	+0.61	2.92	3.75	+0.83	+0.22
Status asthmaticus	2.77	3.46	+0.69	2.57	3.31	+0.74	+0.1

Generalized linear model. Mean comfort score on a 0–5 point scale.

^aItems taught in week 1 of the new PEM-SIM curriculum.

*p<0.05.

Table 2 Mean scores for knowledge assessment

	Traditional (n=48)			PEM-SIM (n=61)
	Pre-test	Post-test	Δ	Pre-test	Post-test	Δ	p*
Mean score (SD)^a	7.6 (2.1)	8.6 (2.9)	+1	7.5 (2.1)	10.4 (1.8)	+2.9	<0.001

*Mann–Whitney U.

^aScore=number correct out of 15 questions.

Table 3 Approximate startup costs for the PEM-SIM curriculum

AED trainer	$407.00
Pediatric PIV task trainer set	$400.00
Urinary catheter male/female trainer set	$2,907.00
Infant lumbar puncture task trainer	$506.00
ALS infant mannequin	$2,343.60
Adult intubation task trainer	$1,895.00
3.0 nylon sutures	$36.98/box (12)
20 gauge PIV catheters	$123.40/case (200)
Urinary catheters 12 Fr 16"	$7.60/box (10)
Abscess incision/drainage set	$83.48/box (20)
Suture removal kit (scissors/forceps)	$93.00/box (50)
Pediatric AMBU bag/mask	$11.86
3 inch compression bandages	$9.75/box (10)
3 inch Webril	$16.21/bag (20)
3 inch×9 ft plaster rolls	$10.65/box (12)
Basic kitchen sponges (laceration models)	$3.99 (12)
Ripe oranges (abscess models)	$5.99/bag (6)
Approximate startup costs	$8,861.51