gms | German Medical Science

Background: At our institution, severely injured children require admission to the adult emergency department (ED), where sectional imaging and low dose X-ray (LODOX) are readily available. However, multiple challenges remain for optimally ensuring patient safety with a consistently alternating trauma team consisting of adult and pediatric physicians not routinely working together.

Methods: To address this issue, we implemented regular in-situ simulation-based multidisciplinary, interprofessional team training into routine clinical practice. From January to December 2015, nursing and medical staff conjointly participated in our quarterly half-day scenario-based program. We aimed to evaluate the impact of simulation on the preparedness for pediatric trauma by a post-course survey.

Results: Twenty-eight participants (5 nurses, 21 physicians, 2 medical students) from adult and pediatric emergency medicine and pediatric surgery completed the survey; 23/28 had previous simulation experience; 13/28 advanced trauma life support (ATLS) provider certification. Realism was felt to be very strong by 10/28 participants. Half of the attendees reported to have gained significant new medical (n=15/28) and crisis resource management (CRM) knowledge (n=14/28), respectively. Four in 5 attendees very strongly thought that simulation was an effective teaching tool. General feedback included the request for more frequent team trainings tailored to the real situation, increased team thinking and self-confidence.

Discussion: Patient outcome strongly depends on medical and non-technical skills of a multidisciplinary body. Implementation of continuous team training for all personnel involved in the acute management of critically injured children in our institution increases team preparedness and self-confidence. The value of in-situ simulation-based team training in realistic circumstances is highlighted.