Yale School of Medicine
POISE Network-Patient Outcomes
in Simulation Education
A multi-centered study to evaluate the effectiveness of simulation on patient outcomes
A critically ill infant is afforded the best opportunity for survival when pediatric providers rapidly perform life saving interventions with minimal errors. Provider performance can be improved through effective education and training. However, most providers develop their skills through a traditional trial and error process. Current training involves watching a more experienced provider perform a complex skill and then practicing that skill for the first time on the next patient. We believe this apprenticeship model of, “see one, do one, teach one,” is not ethical. The patient suffers the consequences of an inexperienced provider making mistakes while developing their skills. This method of training is unacceptable in other high stakes environments, such as aviation. Society would not allow a novice pilot to “learn from mistakes” while flying a plane. The trainee should not be expected to perform a complex procedure after watching the procedure only once and without any hands on practice. How does one perfect a technique with hands-on practice without laying hands on a patient?
Simulation training has reduced the number of accidents in the aviation industry. The pilot must demonstrate mastery in the flight simulator before they are allowed to perform in real life. Repetition and practice is an integral part of becoming a proficient expert. The American College of Graduate Medical Education has accepted simulation as an effective method for both teaching and evaluating procedural skills. Accrediting organizations such as JCAHO and AHRQ are mandating competency based performance measures that use simulation. The FDA has mandated endovascular surgeons demonstrate competence on a carotid artery simulator prior to operating and Israel has mandated simulation credentialing on procedures for anesthesia providers. Unfortunately pediatrics has lagged behind these other specialties and little data exists on the effectiveness of simulation training on patient outcomes.
Our goal is to develop an evidence base that demonstrates the effectiveness of simulation training, testing, and credentialing for improving pediatric acute care skills. Once the evidence is accumulated performing in a simulated environment could become mandatory for practitioners to become licensed to care for acutely ill and injured children. Ultimately improved training will lead to a reduction in pediatric morbidity and mortality. The overarching aim of our work is to improve outcomes in pediatric patients through the development of evidence based simulation educational interventions.
R Baby-sponsored POISE Network
Is Saving Babies' Lives
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Video generously donated by OneMedPlace.
