Copyright
©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
Interprofessional, multiple step simulation course improves pediatric resident and nursing staff management of pediatric patients with diabetic ketoacidosis
Linnea M Larson-Williams, Amber Q Youngblood, Dawn Taylor Peterson, J Lynn Zinkan, Marjorie L White, Hussein Abdul-Latif, Leen Matalka, Stephen N Epps, Nancy M Tofil
Linnea M Larson-Williams, Department of Pediatric Endocrinology, Georgia Regents University, Augusta, GA 30912, United States
Amber Q Youngblood, J Lynn Zinkan, Children’s of Alabama, Pediatric Simulation Center, Birmingham, AL 35233, United States
Dawn Taylor Peterson, Department of Medical Education, University of Alabama School of Medicine, Birmingham, AL 35233, United States
Marjorie L White, Department of Pediatric Emergency Medicine, Office of Interprofessional Simulation, University of Alabama at Birmingham, Birmingham, AL 35233, United States
Hussein Abdul-Latif, Department of Pediatric Endocrinology, University of Alabama at Birmingham, Birmingham, AL 35233, United States
Leen Matalka, Pediatric Residency, University of Alabama at Birmingham, Birmingham, AL 35233, United States
Stephen N Epps, Department of Pediatrics, Louisiana State University, Baton Rouge, LA 70803, United States
Nancy M Tofil, Department of Pediatric Critical Care, University of Alabama in Birmingham, Birmingham, AL 35233, United States
Author contributions: Larson-Williams LM led all simulation sessions, designed the initial simulation, knowledge tests and assisted in manuscript writing and editing; Youngblood AQ assisted with simulations, manuscript writing and editing; Peterson DT assisted with study design, manuscript editing; White ML assisted with simulation sessions, study design, manuscript editing; Abdul-Latif H assisted with simulation design, knowledge tests and manuscript editing; Matalka L and Epps SN assisted with data review and statistics and manuscript writing; Tofil NM was senior advisor overseeing study design, simulation session, statistical analysis and manuscript writing and editing; all authors contributed to this paper.
Supported by A University of Alabama at Birmingham Department of Pediatrics Founders Fund Grant.
Institutional review board statement: This study was approved by the ethics committee at University of Alabama at Birmingham.
Informed consent statement: All subjects gave informed consent.
Conflict-of-interest statement: No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
Data sharing statement: Technical appendix, statistical code and dataset available from the corresponding author at ntofil@peds.uab.edu.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Nancy M Tofil, MD, Department of Pediatric Critical Care, University of Alabama in Birmingham, 1600 5
th Ave South CPPI 102, Birmingham, AL 35233, United States.
ntofil@peds.uab.edu
Telephone: +1-205-6389387 Fax: +1-205-9756505
Received: May 17, 2016
Peer-review started: May 17, 2016
First decision: July 5, 2016
Revised: July 20, 2016
Accepted: August 6, 2016
Article in press: August 8, 2016
Published online: November 4, 2016
Processing time: 170 Days and 10.8 Hours
AIM
To investigate the use of a multidisciplinary, longitudinal simulation to educate pediatric residents and nurses on management of pediatric diabetic ketoacidosis.
METHODS
A multidisciplinary, multiple step simulation course was developed by faculty and staff using a modified Delphi method from the Pediatric Simulation Center and pediatric endocrinology department. Effectiveness of the simulation for the residents was measured with a pre- and post-test and a reference group not exposed to simulation. A follow up post-test was completed 3-6 mo after the simulation. Nurses completed a survey regarding the education activity.
RESULTS
Pediatric and medicine-pediatric residents (n = 20) and pediatric nurses (n = 25) completed the simulation course. Graduating residents (n = 16) were used as reference group. Pretest results were similar in the control and intervention group (74% ± 10% vs 76% ± 15%, P = 0.658). After completing the intervention, participants improved in the immediate post-test in comparison to themselves and the control group (84% ± 12% post study; P < 0.05). The 3-6 mo follow up post-test results demonstrated knowledge decay when compared to their immediate post-test results (78% ± 14%, P = 0.761). Residents and nurses felt the interdisciplinary and longitudinal nature of the simulation helped with learning.
CONCLUSION
Results suggest a multidisciplinary, longitudinal simulation improves immediate post-intervention knowledge but important knowledge decay occurs, future studies are needed to determine ways to decrease this decay.
Core tip: Our paper describes how an interprofessional simulation improved the understanding of the medically complex disorder of pediatric diabetic ketoacidosis (DKA). This was shown in our data collection both by improvements in test scores from pre-simulation to post-simulation, as well as when compared to the control group. Few studies have looked at simulation as an educational tool for DKA. Our simulation course identified gaps in knowledge, communication, and patient care. Therefore, demonstrating that interprofessional simulation is a useful tool to teach a team based approach and focus on communication between nursing staff and physicians when taking care of critically ill children.
