Teaching pediatric emergency department agitation management using a clinical pathway combined with simulation scenarios

Abstract

Background

Agitation is a common cause for pediatric emergency department (ED) visits. Despite consensus guidelines and recent educational toolkits, opportunities exist to improve provider knowledge and patient care by utilizing novel teaching modules.

Objectives

This study aimed to develop and test a teaching module (intervention) using two clinical case simulations and a pediatric agitation pathway (decision aid). We hypothesized that the module would improve provider knowledge and comfort in managing acutely agitated pediatric patients.

Methods/Design

This single-center, pre-post intervention study used a multidisciplinary-developed pathway based on consensus guidelines and two simulation case scenarios.

Subjects and Setting

Participants, all trainees in emergency medicine, completed a knowledge test and comfort survey prior to the training. They then attended a brief teaching session on the pathway, participated in two simulation case scenarios, and subsequently repeated the test and survey. Outcome measures were the difference between knowledge and comfort scores before and after the training.

Results

Sixteen participants completed the module. Knowledge improved significantly, with mean test scores increasing from 4.5 out of 10 (IQR 3–5) to 8 out of 10 (IQR 7–9) (P < .001). Comfort improved with using chemical (P = .002) and physical (P = .001) restraints.

Conclusion

The findings suggest that a teaching module for pediatric agitation which uses a decision aid in simulation scenarios is feasible and effective in improving overall knowledge and comfort associated with pediatric chemical and physical restraint use. It fills a well-known gap in pediatric agitation training and has the potential to be replicated in teaching programs for other emergent conditions.