Simulation Platforms to Train and Assess Pediatric Acute Care Procedural Skills: A Scoping Review

Background

Medical trainees have limited opportunities to practice certain pediatric emergency medicine (PEM) procedures in the clinical setting. Simulation-based education provides an opportunity for trainees to improve their technical and non-technical skills. This scoping review aimed to explore the ways in which simulation has been used to train and assess medical learners.

Methods

A search was conducted from 2011 to August 2022 using MEDLINE, OVID Embase, OVID Emcare, and Cochrane Trials, among others. The review included empirical studies that used simulation for training medical trainees in four essential pediatric procedures: intubation, lumbar puncture, intraosseous insertion, and chest tube insertion. Six reviewers independently screened titles, abstracts, and full texts. Data were recorded, stored, and summarized in a standardized spreadsheet.

Results

The search retrieved 4073 articles, of which 207 underwent full-text screening. Data were extracted from 107 studies. Among these, 69 studies focused exclusively on intubation skills, 19 studies on lumbar puncture, 10 studies on intraosseous insertion, and two studies on chest tube insertion. The majority of studies (n = 61) involved residents, while 15 studies focused on medical students. Training platforms included mannequins (n = 84), ex-vivo models (n = 6), task trainers (n = 4), and standardized patients (n = 1). Competency was largely assessed using an assessment tool (n = 45) as the sole assessment method.

Conclusions

Simulation-based training and assessment can support medical learners in developing key technical and non-technical skills related to PEM procedures. However, there is a need for diversification of simulation platforms used, expansion of procedures targeted in simulation-based training and assessment programs, and creation of standardized and procedure-specific assessments.