2. I have no conflict of interests to disclose

3. 0-5min Introduction/Turning Point Slides 5-15min Objectives 15-45min Review Pediatric courses and opportunities 45-60min TAPPS – List barriers and discuss strategies to overcome to overcome the barriers 60-75min Wrap-up / Top 10

4. 1.0-6months 2.6-12months 3.12-18 months 4.18-24 months 5.2-5 years 6.> 5years

5. 1.Simulation technologist 2.Nurse educator 3.Physician/ Advanced provider 4.Administrator 5.Other

6. 1.Nurse 2.Medical Student 3.Resident 4.Staff Physician 5.EMT 6.Other

7. 1.Free standing 2.In hospital 3.In nursing or allied health school 4.In medical school 5.Other

8. 1.Laerdal SimBaby 2.Laerdal SimNewB 3.METI Child 4.Gaumard 5.More than one type 6.None yet

9. 1.Financial related 2.Technical knowledge 3.Time constraints 4.Hospital support

10. 1.Programming Advice 2.Ideas for pediatric sim courses 3.Strategies to move your center ahead 4.Product advice 5.Obtain new scenarios 6.Other

11. 1.Discuss the medical/legal environment in the pediatrics area 2.Identify issues specific to pediatric care 3.Describe the history of pediatric simulation 4.Describe the role of simulation in providing quality pediatric education 5.Discuss collaboration with multidisciplinary leadership 6.Describe how to plan and implement pediatric simulation 7.Define measurable objectives for success

12. 1.Patient safety 2.Resident duty hours 3.Transition of responsibility to fellows and attendings 4.Nursing students less exposure 5.New nurses less skilled

13. Multiple sizes Multiple normal values – Vital Signs – Laboratory Values – Radiograph findings Many patients unable to explain their concerns Interaction of care givers Social concerns Kids are never supposed to die

14. Laerdal SimBaby – released 2005 Laerdal SimNewB – released 2009 METI Child – released 2006 Gaumard HAL – released early 2000’s Laerdal SimChild - soon Always behind adult technology Never will have as much potential profit

15. 1.Clinical Education Inefficient 2.No Debriefing 3.No scheduled admissions

17. John Dewey, “All genuine education comes about through experience but not all experience educates and some experience mis-educates” Experience is the backbone of adult learning theory

18. Concrete Experience Reflective Observation Abstract conceptualization Active experimentation Debriefing Relating to actual situations, developing rules, algorithms Practicing *Kurt Lewen Simulation 1.Standardize exposure 2.Scheduled debriefing

19. Began August 2007 8 Mannequins 3 Simulation rooms Conference room Audiovisual capability in all rooms Storage

22. SimBaby x2 SimNewB SimMan SimMan Essential METI PediaSim Gaumard Pediatric Hal 1 Year Gaumard Pediatric Hal 5 Year

23. 1.Radiology (Attending and Technologist) 2.ECMO (ECMO Team) 3.PICU (Physician, Nurse and Pharmacy) 4.Mock Code (Code Team) 5.Trauma (Trauma Team) 6.Death and Dying (Physician, Nurse, Social Work and Chaplain) 7.Forensic Evidence (Physician, Nurse) 8.Medical Student Clerkship (Medical, Nursing and Pharmacy Students) 9.Sedation (Physician, Nurse, Technologist) 10.Cardiovascular (Physician, Nurse Practitioner, Nurse)

30. 1.Orthopedics 2.Anesthesia and CRNA 3.Pharmacy Student 4.PICU Nursing 5.Solid Organ Transplant Nursing 6.Dialysis Nursing 7.NICU Nursing

34. 1.Nursing Skills Labs (First 5 Minutes of a Code) 2.PALS 3.Geriatrics 4.NRP 5.Clinical Assistant 6.New Hire Nursing Assessment 7.Sleep Technologists 8.Nursing Mock Code Orientation 9.Home Ventilator 10.Teen Trauma Prevention 11.Medication Errors

37. Tracheostomy Intubation Basic Airway Surgical Airway Crisis Resource Management Intern Skills ENT Foreign Body Removal

41. Request comes in or need identified Face to face meeting Content expert identified Learners identified Goals and objectives What simulation can and cannot do Specific cases discussed IDEAS FOR CASES 1.Sentinel events 2.Near misses 3.Rare events (contrast reactions) 4.Safety & equipment issues 5.Requests 6.Codes 7.Premature Closure 8.Hand offs

42. Who? Learners, content expert, simulation staff What? Objectives, take away points When? Frequency Where? Simulation Center, in situ, somewhere else Why? Change in knowledge, skills, attitudes How? Moulage, labs, xrays, equipment RESOURCES 1.Online: forms, scenarios, programming, moulage 2.Internal: staff 3.Networking 4.Organizations 5.List serves

43. Moulage Family members Xrays, labs, ECG Clothes, wigs, toys, eyeglasses Voices Use real equipment (no pretending) Unusual distracters (impaired clinician, family issues)

46. I am a MD RN Resp Therapy Pharmacist Radiology Tech Nursing Student Medical Student Chaplain Social Work Other_______ AgreeNeither Agree nor Disagree Disagree I found to be valuable learning experience. Debriefing and group discussion were valuable learning Experiences. I will be able to apply what I have learned in my work position/job. I was challenged in my thinking and decision-making skills. I developed a better understanding of the management of pediatric disorders/emergencies. This experience has increased my confidence level in pediatric disorders/emergencies This experience has increased my skill level in pediatric disorders/emergencies. I feel better prepared to care for real pediatric patients. I learned as much from observing my peers as I did when I was actively involved in caring for the simulated patient. I would recommend this program to others. The Instructor(s) was knowledgeable about the subject(s) presented. My personal objectives for this course were met.

47. 1.Do you feel your participation in this course will improve your performance as you encounter medical complications in the actual clinic setting? 2.Two things I liked/learned today: a) b) 3.Two things I wish we had focused on or that could be improved: a) b) Comment/Suggestions/Recommendations:

48. TAPPS – Think Aloud Paired Problem Solving 1 Active Learning Technique Pair up Discuss proposed problem As instructor state, “We will do this exercise for ___ minutes. I will give you a 1 min heads up. At the completion of the exercise I will call on some groups to share their thoughts. Does anyone have any questions before we get started.” 1. Harvey Brighton

49. 10. Simulator Voice – 10W Guitar Amp ($60) – RadioShack 170 MHZ wireless lapel microphone ($50) – 72inch LPM cable ($5) PRICELESS

50. 9. Caregiver (parent, spouse, child) – Hospital volunteer – Medical student

51. 8. Free/ Nearly Free Supplies – X-rays – Laboratory reports – Costumes (thrift stores) – Trash bins (Stroller, IV pumps) – Expired medical supplies

52. 7. Short scenarios (10-15min) and long debriefings (20-45min) – Start with scenarios you feel most comfortable with and expand from there – Same stem for multiple learners – make it more gray for more advanced learners JW, F8 def – Change rhythms

53. 6. The Basic Assumption Everyone participating in activities at the Children’s Hospital Pediatric Simulation Center is intelligent, well- trained and dedicated to improve their care for children. 1 1. Adapted from Center for Medical Simulation, Boston MA

54. 5. Relatively simple video system – Video-switcher Picture in Picture – Apple – I Movie

55. 4. Weekly simulation team meetings – Keeps everyone accountable to each other

56. 3. Make friends – High and Low Places – Housecleaning – Pharmacy – Engineering – Security – Hospital volunteers – Hospital CEO

57. 2. Candy!! – Everyone learns more when fed!!

58. 1.Have fun and keep it simple Celebrate Success

59. I hear and I forget I see and I remember I do and I understand Confucius, 551-479 BC