ACEP SimBox: A Pediatric Simulation-Based Training Innovation - 20/08/21

Doi : 10.1016/j.annemergmed.2021.03.040

Samreen Vora, MD, MHAM ^a,^⁎ , Joyce Li, MD, MPH ^b, Maybelle Kou, MD, MEd ^c, Vivienne Ng, MD, MPH ^d, Amanda Price, MD ^e, Ilene Claudius, MD ^f, Shruti Kant, MD ^g, Elizabeth Sanseau, MD, MS ^h, Manu Madhok, MD ^a, Marc Auerbach, MD, MSc ⁱ
^a Department of Emergency Medicine, Children’s Minnesota Hospital, Minneapolis, MN
^b Division of Emergency Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, MA
^c Department of Emergency Medicine, Inova Fairfax Medical Campus/Inova Children’s Hospital, Falls Church, VA
^d Department of Emergency Medicine, The University of Arizona, Tucson, AZ
^e Division of Pediatric Emergency Medicine, Medical University South Carolina, Charleston, SC
^f Department of Emergency Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA
^g Department of Emergency Medicine, Benioff Children’s Hospital, San Francisco, CA
^h Division of Emergency Medicine, Children’s Hospital of Philadelphia, Philadelphia, PA
ⁱ Department of Pediatrics, Department of Emergency Medicine, Yale University School of Medicine, New Haven, CT

^∗Corresponding Author.

Abstract

Thirty million pediatric visits (<18 years old) occur across 5,000 US emergency departments (EDs) each year, with most of these cases presenting to community EDs. Simulation-based training is an effective method to improve and sustain EDs’ readiness to triage and stabilize critically ill infants and children, but large simulation centers are mostly concentrated at academic hospitals. The use of pediatric simulation-based training has been limited in the community ED setting due to the high cost of equipment and limited access to content experts in pediatric critical care. We designed an innovative “off-the-shelf” simulation-based training resource, “American College of Emergency Physicians (ACEP) SimBox,” that provides a free low-technology manikin along with teaching aids and train-the-trainer materials to community EDs to run a simulation drill in their own workspaces with local educators. The goal was to develop an “off-the-shelf,” free, open-access, simulation-based resource to improve the readiness of community EDs to triage, resuscitate, and transfer critically ill infants as measured by presimulation and postsimulation surveys measuring opinions regarding the scenario, session experience, and most valuable aspect of the session. Between January 2018 and December 2019, 179 ACEP SimBoxes were shipped across the United States, reaching 36 of 50 states. Facilitators and participants who completed the postsimulation survey evaluated the session as a valuable use of their time. All facilitator respondents reported that the low-technology manikins, paired with their institution-specific equipment, were sufficient for learning, thus reducing costs. All participant respondents reported an increased commitment to pediatric readiness for their ED after completing the simulation session. This innovation resulted in the implementation of a unique simulation-based training intervention across many community EDs in the United States. The ACEP SimBox innovation demonstrates that an easy to use and unique simulation-based training tool can be developed, distributed, and implemented across many community EDs in the United States to help improve community ED pediatric readiness.

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Plan

Introduction

Background

Objective of Innovation

Development Process

The Implementation Phase

Marketing and Recruitment

Evaluation

Outcomes

Reflective Discussion

Adaptations

Conclusion

	Supervising editor: Jocelyn Gravel, MD. Specific detailed information about possible conflict of interest for individual editors is available at editors.
	All authors attest to meeting the 4 ICMJE.org authorship criteria: (1) Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; AND (2) Drafting the work or revising it critically for important intellectual content; AND (3) Final approval of the version to be published; AND (4) Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
	Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE conflict of interest guidelines (seewww.icmje.org). ACEP SimBox was funded by 2 ACEP Pediatric Emergency Medicine Section grants in 2017 and 2019.
	Presentation information: This work has not been presented as a poster or oral presentation at any meetings. The ACEP SimBox was displayed and demonstrated in the Exhibit Hall at the 2019 Advanced Pediatric Emergency Medicine Assembly in Orlando, Florida and the 2019 ACEP Scientific Assembly in Denver, Colorado.