Background: Management of the acutely ill children represents one of the more complex clinical skills required of pediatric physicians.This study aimed to evaluate the impact of regular team training on the knowledge and comfort level reported by the physicians participating in codes and real life resuscitations. Methods: We performed a before and after evaluation of residents of our pediatric program. Over a period of two months, the residents were educated by running five mock code cases followed by debriefing. Before and after the five sessions, the residents completed a self-assessment questionnaire. Results: Residents reported a significant improvement in their comfort in all aspects of managing pediatric resuscitations, with notable improvement seen in running a resuscitation requiring airway management (median pre 2, post 3, p < 0.001); running a resuscitation of shock requiring fluid resuscitation (median pre 3, post 4, p < 0.001); and performing endotracheal intubation (median pre 2, post 4, p < 0.001). The most prominent change was demonstrated in the comfort level of the overall management of a pediatric resuscitation, with a decrease of the bottom scores (1+2) from 18 physicians (75%) pre-intervention to one physician (4%) post-intervention. Conclusion: The pediatric mock code educational training program improved residents' self-reported knowledge and comfort level in managing pediatric emergency situations. Integration of in situ simulation team training in departments where residents run most of the codes has the potential to improve their performance in real-life resuscitations. A continuous mock code program will provide residents with critical skills training and experience.
