Faking it: Evaluating the Effectiveness of Low-Fidelity Simulation-Based Paediatric Teaching in a District Hospital

Background: Simulation-based teaching has become a key part of Paediatric training by allowing the development of the skills and knowledge to manage conditions and emergencies which are infrequently encountered in clinical practice. The current literature of simulation-based teaching focuses on large paediatric units with high-cost training programs, which could be prohibitively expensive for district hospitals.

Objectives: By conducting this prospective observational study we aimed to evaluate the low-fidelity ward-based simulation being conducted in Harrogate District Hospital. We aimed to demonstrate its effectiveness as well as assess participant’s attitudes towards this method of teaching.

Methods: Low-fidelity simulation-based teaching sessions were undertaken with a multi-disciplinary team during periods of low ward activity. They used a simple mannequin with expired, or spare, equipment and were run by the Consultant on the ward. Questionnaires were distributed to evaluate the participants attituded towards simulation as well as their confidence levels before and after simulation of Paediatric and Neonatal emergency scenarios. A total of 24 responses were received and included in this study.

Results:

• 100% of participants agreed, or strongly agreed, they wanted more simulation-based teaching.
• The average feedback from participants was agreement that these sessions improved their knowledge, communication, leadership, decision-making, and day-to-day practice.
• There was a statistically significant increase in participant`s confidence levels with regards to: preparedness to manage emergencies (p=0.001), understanding their role (p=0.008), leadership ability (p=0.002), escalating to seniors (p=0.014), practical skills (p=0.012), communicating effectively (p=0.025), and ability to recognise unwell children (p=0.034).

Conclusion: This study demonstrated that low-fidelity simulation undertaken at low cost is an effective and flexible teaching method which is regarded highly by participants. There is a high demand from trainees for more simulation-based teaching and we hope the flexibility and effectiveness demonstrated in this study helps to encourage more widespread use.