Diverse Approach to Utilizing Simulation-Based Education in the Medically Complex Pediatric Patient

Introduction: The Progressive Care Unit (PCU) at the Children’s Hospital of Philadelphia is a 24-bed subset of Pediatric Critical Care that specializes in medically complex children requiring invasive mechanical ventilation.

Tracheostomy emergency response is critical and can lead to significant morbidity if not managed promptly and effectively. How can we prepare doctors, nurses, and families to safely care for these medically complex patients, without putting them at risk? A need for hands-on training was identified to better prepare families and staff to care for these patients.


Methods: All scenarios were designed using previous real-life emergencies and objectives for this patient population; simulations employed authentic equipment used in patient care.​

A set of core competencies were:​

Embedded in the clinical education preceding simulations​

Included in the standardized training checklist used during every simulation​

Discussed during the post-simulation debrief and informed just-in-time education​

Surveys to assess self-reported participant experience via Likert-scale responses were collected post-simulation using REDCap (1=strongly disagree, 2=disagree, 3=neutral, 4=agree, 5=strongly agree).​


Results: 117 simulations have been completed from April 2023- November 2024:​

Most respondents reported that the simulation enhanced their confidence, the content was relevant, and the learning environment felt psychologically safe.​


Conclusions: This high-fidelity simulation training, which focuses on emergency scenarios for tracheostomy-dependent pediatric patients, can be easily adapted for use with diverse populations.​

Post-simulation survey responses indicated that the simulation enhanced participants' confidence, provided relevant content, and fostered a psychologically safe learning environment.​

Future work will standardize simulation-based evaluation by incorporating validated tools to measure self-reported confidence, objectively assess skill competency gained through this high-fidelity simulation-based training program and implement periodic reevaluations to monitor long-term skill retention.​