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Thirty million pediatric visits (

SUMMARY STATEMENT Simulation-based education is a particularly germane strategy for addressing the difficult topic of racism and implicit bias due to its immersive nature and the paradigm of structured debriefing. Researchers have proposed actionable frameworks for implicit bias education, particularly outlining the need to shift from recognition to transformation, with the goal of changing discriminatory behaviors and policies. As simulation educators tasked with training health care professionals, we have an opportunity to meet this need for transformation. Simulation can shift behaviors, but missteps in design and implementation when used to address implicit bias can also lead to negative outcomes. The focus of this article is to provide recommendations to consider when designing simulation-based education to specifically address racism and implicit bias.

Simulation-based education is a particularly germane strategy for addressing the difficult topic of racism and implicit bias due to its immersive nature and the paradigm of structured debriefing. Researchers have proposed actionable frameworks for implicit bias education, particularly outlining the need to shift from recognition to transformation, with the goal of changing discriminatory behaviors and policies. As simulation educators tasked with training health care professionals, we have an opportunity to meet this need for transformation. Simulation can shift behaviors, but missteps in design and implementation when used to address implicit bias can also lead to negative outcomes. The focus of this article is to provide recommendations to consider when designing simulation-based education to specifically address racism and implicit bias.

Every year, millions of pediatric patients seek emergency care. Significant barriers limit access to optimal emergency services for large numbers of children. The American Academy of Pediatrics, American College of Emergency Physicians, and Emergency Nurses Association have a strong commitment to identifying these barriers, working to overcome them, and encouraging, through education and system changes, improved access to emergency care for all children.

OBJECTIVE: To describe the impact of a national interventional collaborative on pediatric readiness within general emergency departments (EDs). STUDY DESIGN: A prospective, multicenter, interventional study measured pediatric readiness in general EDs before and after participation in a pediatric readiness improvement intervention. Pediatric readiness was assessed using the weighted pediatric readiness score (WPRS) on a 100-point scale. The study protocol extended over 6 months and involved 3 phases: (1) a baseline on-site assessment of pediatric readiness and simulated quality of care; (2) pediatric readiness interventions; and (3) a follow-up on-site assessment of WPRS. The intervention phase included a benchmarking performance report, resources toolkits, and ongoing interactions between general EDs and academic medical centers. RESULTS: Thirty-six general EDs were enrolled, and 34 (94%) completed the study. Four EDs (11%) were located in Canada, and the rest were in the US. The mean improvement in WPRS was 16.3 (P

In 2014, the six allopathic emergency medicine (EM) residency programs in Chicago established an annual, citywide, simulation-based assessment of all postgraduate year 2 EM residents. The cases and corresponding assessment tools were designed by the simulation directors from each of the participating sites. All assessment tools include critical actions that map directly to numerous EM milestones in 11 different subcompetencies. The 2-hour assessments provide opportunities for residents to lead resuscitations of critically ill patients and demonstrate procedural skills, using mannequins and task trainers respectively. More than 80 residents participate annually and their assessment experiences are essentially identical across testing sites. The assessments are completed electronically and comparative performance data are immediately available to program directors.

OBJECTIVES There is currently no consolidated list of existing simulation fellowship programs in emergency medicine (EM). In addition, there are no universally accepted or expected standards for core curricular content. The objective of this project is to develop consensus-based core content for EM simulation fellowships to help frame the critical components of such training programs. METHODS This paper delineates the process used to develop consensus curriculum content for EM simulation fellowships. EM simulation fellowship curricula were collected. Curricular content was reviewed and compiled by simulation experts and validated utilizing survey methodology, and consensus was obtained using a modified Delphi methodology. RESULTS Fifteen EM simulation fellowship curricula were obtained and analyzed. Two rounds of a modified Delphi survey were conducted. The final proposed core curriculum content contains 47 elements in nine domains with 14 optional elements. CONCLUSION The proposed consensus content will provide current and future fellowships a foundation on which to build their own specific and detailed fellowship curricula. Such standardization will ultimately increase the transparency of training programs for future trainees and potential employers.

Background Pediatric mock code simulation plays a critical role in the development of a trainee's decision making ability for high-stakes, low frequency situations. To ensure trainees receive maximal benefit from these simulations, it is important that they receive optimal, timely feedback. Objective The aim of this study is to characterize the implementation and pilot use of the American Board of Pediatrics’ (ABP) Entrustable Professional Activities (EPAs) for mock code feedback. Methods We designed a simulation-based education intervention study of pediatric trainees at a large pediatric residency program. To ensure consistency and breadth of experience, a standardized mock code curriculum of 13 cases was created. An online assessment tool was created based on the ABP's EPA 10 (resuscitation and initial stabilization) incorporating objective clinical behaviors that the learner must display during the simulation. EPAs and communication were rated based on narrative anchors with seven and five possible levels, respectively. The tool was used to facilitate and record feedback between the instructor and trainee. In addition, other mock code participants evaluated the trainee using the tool in real time. Results 6 months since implementation, 21 residents (45% of PGY-2, PGY-3 classes) have received one-to-one verbal and written feedback using our tool following a mock code. 90 evaluations were completed by faculty and observers. The average EPA rating and communication score of residents was 5.4 (SD 1.27) and 3.66 (SD 0.75), respectively. There were no significant differences observed in the EPA or communication scores between the observers and faculty (P = 0.46 and 0.8, respectively). In the post-simulation survey, 93% (13/14) of trainees indicated the feedback process would improve their future performance. Conclusions An EPA-based, online assessment tool was feasible and easily incorporated into mock code simulations. We found that observers with varying levels of expertise gave similar ratings, suggesting future possibilities of using peers for feedback in mock code settings.