Pediatric Critical Skills Curriculum Development Project

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Pediatric Critical SkillsCurriculum Development
Project

• Keith P. Bly, MD
• Assistant Professor, Pediatrics
• Division of General Inpatient Pediatrics
• UTMB Galveston

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Pediatric Critical Skills

• Pediatric Critical Skills
• Knowledge Base
• Practical Skill Set
• Performance Integration
• Cardiopulmonary Resuscitation
• IV Moderate/Deep Procedural Sedation

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Pediatric Critical Skills

• Resuscitations few and far between
• Expected to provide moderate/deep sedation
• Historic current teaching methods
• ALS courses (PALS, NALS, ACLS)
• On-the-Job patient based bedside training
• Resident performance and feedback indicates gaps
• RRC Recommendations

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Goals Objectives Knowledge

• At completion of the Critical Skills Curriculum,
  residents will...
• Know proper resuscitation algorithms
• Correctly utilize code medications and doses
• Recognize appropriate indications, necessary
  preparation, and optimal safe delivery of IV
  moderate or deep sedation

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Goals Objectives Skills

• At completion of the Critical Skills Curriculum,
  residents will be competent with...
• O2 delivery, BVM airway management systems
• CPR skills and resuscitation algorithms
• IV/IO Access
• Proper equipment size medication doses
• PALS algorithms
• Administration of moderate/deep sedation

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Goals Objectives Performance

• At completion of the Critical Skills Curriculum,
  residents will...
• Correctly and efficiently perform the
  role-specific skills necessary for an effective
  pediatric resuscitation
• Possess the necessary skills to conduct mock
  codes apropos to their future area of practice
• Competently prepare for and administer IV
  moderate/deep procedural sedation

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Target Audience

• UTMB Pediatric Residents
• Level-specific Goals Objectives
• Evaluations (PL 1-3)
• Faculty Participants
• Selection training on equipment, scenarios,
  evaluations and debriefing
• Nursing, Respiratory Therapy, Ancillary Staff

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Teaching Methods

• Longitudinal Experiences
• Core Lecture Series
• Supervised Procedure Logs
• Mock Code Scenarios

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Teaching Methods

• Block Experiences
• PALS, NALS, PALS instructor courses
• Critical Skills Rotation (2 weeks)
• Sedations - Bedside Clinical Experience
• Simulation Labs
• Readings/Syllabus
• Pre Post Test

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Curriculum Roadmap
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PL-2 Critical Skills Rotation
2 Week Rotation
OR Airway - 5 mornings Sim Lab, IV Lab - 2 half
days each Mock Code participation - 2 half days
Schedule subject to change due to sedations
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Mock Code Implementation

• Scenarios
• Handbook of Pediatric Mock Codes, Roback Teach,
  1998
• Faculty PL-2 resident run, evaluate, debrief
• Frequency Location
• 2-3 times per month
• Any area of the hospital

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Mock Code Implementation

• The Theatre
• Mock Code Cart, equipment, mannequins
• Code pager system
• Reality vs. Practicality
• Clinical setting
• Mock Code Lab

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Mock Code Evaluation

• Performance Evaluation Tool
• Team Evaluation Checklist Comments
• Performance Improvement Worksheet
• Resident Performance Evaluation Gradesheet
• Debriefing Exercise
• Team discussion, written feedback
• Videotaping

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Curriculum Evaluation

• Residents
• Scenario specific feedback
• Pre/post testing
• Comfort confidence survey
• Megacode performance
• Nursing, Respiratory and Ancillary feedback
• Educational research data

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Challenges to Implementation

• Faculty Support, Time, Effort
• Resident Availability Participation
• Simulation Lab Schedule Cost
• Curriculum Evaluation

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Pediatric Critical Skills

• TARGET START DATE July 2007
• Questions? Suggestions?