Enhancing Transport Medical Control Skills for Pediatric Critical Care Fellows

Introduction: Pediatric intensivists frequently serve as transport medical control (TMC) for critically ill children requiring interfacility transport. Despite the critical nature of this role, formal TMC training in Pediatric Critical Care Medicine (PCCM) fellowships remain inconsistent. A national survey found that while 85% of programs expect fellows to serve as TMC, only 72% provide formal instruction, and just 25% use standardized assessment tools. To address this gap, we developed a structured simulation-based medical education (SBME) curriculum targeting key competencies in transport decision-making, triage, and communication.


Methods: A structured telephone-based simulation and didactic session was implemented in collaboration with PCCM faculty, fellows, and transport nurses. A pre-curriculum needs assessment was obtained from fellows and intensivists. Each fellow completed a simulation session with four scenarios, followed by debriefs. A consensus-based modified assessment tool evaluating three key domains was used for scoring.


Results: Five PCCM fellows underwent training. Preliminary post-simulation assessments showed measurable improvements. In Information Gathering, the mean score increased from 0.636 to 0.876 (Δ = 0.24; 95%CI: 0.11–0.59). In Medical Knowledge and Decision-Making, scores improved from 0.600 to 0.702 (Δ = 0.074; 95%CI: 0.24 to 0.43). In Communication, scores increased from 0.540 to 0.766 (Δ = 0.226; 95%CI: 0.051–0.503), showing a statistically significant improvement. Fellows reported greater confidence in managing transport scenarios and using structured communication. Debriefs facilitated individualized feedback and skill reinforcement. Ongoing efforts are evaluating fellow performance as TMC in real-world transport encounters.


Conclusions: A structured SBME curriculum significantly improved PCCM fellows’ preparedness for the TMC role, enhancing their clinical reasoning for triage and selecting an appropriate mode of transport and communication during transport of critically ill children. Despite limitations including small sample size and short-term follow-up, this curriculum offers a scalable model for incorporation into pediatric critical care training programs. Future directions include longitudinal evaluation and broader implementation across institutions.