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Repetitive simulation is an effective instructional design within a pediatric resident simulation curriculum
  1. Selin Tuysuzoglu Sagalowsky1,
  2. Kimball A Prentiss2,
  3. Robert J Vinci3
  1. 1 Departments of Emergency Medicine and Pediatrics, Columbia University College of Physicians and Surgeons, NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, New York, USA
  2. 2 Department of Emergency Medicine, Baystate Medical Center at Tufts University School of Medicine, Springfield, Massachusetts, USA
  3. 3 Department of Pediatrics, Boston University School of Medicine, Boston, Massachusetts, USA
  1. Correspondence to Dr Selin Tuysuzoglu Sagalowsky, Departments of Emergency Medicine and Pediatrics, Columbia University College of Physicians and Surgeons, NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY 10032, USA; ss4588{at}


Introduction Repetitive paediatric simulation (scenario-debrief-scenario; RPS) is an instructional design that allows immediate application of learner-directed feedback, in contrast to standard simulation (scenario-debrief; STN). Our aim was to examine the impact of RPS embedded within a paediatric resident simulation curriculum, comparing it to STN.

Methods In this prospective educational cohort study, paediatric residents were enrolled in STN (n=18) or RPS (n=15) groups from August 2012 through June 2013. Each group performed an initial high-fidelity simulation and another after 1–2 weeks. Attitudes, confidence and knowledge were assessed using anonymous surveys with each scenario and at 4–6 months. Skills were assessed in real time with a modified Tool for Resuscitation Assessment Using Computerised Simulation (TRACS). Two blinded reviewers assessed a subset of videotaped scenarios for TRACS inter-rater reliability.

Results Both STN and RPS designs were rated highly. The curriculum led to significant short-term and long-term improvements in confidence, knowledge and performance, with no significant differences between groups. All final respondents reported that they would prefer RPS to STN (n=6 STN, 4 RPS). TRACS intraclass correlation was 0.87 among all reviewers.

Conclusions Paediatric residents reported preference for RPS over STN, with comparable impacts on confidence, knowledge and performance. The modified TRACS was a reliable tool to assess individual resident performance. Further research is needed to determine whether RPS is a more effective instructional design for teaching resuscitation skills to paediatric residents.

  • resident education
  • repetitive simulation
  • assessment tools
  • instructional design
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  • Contributors The authors certify that STS is responsible for the original conception and design of this work, acquisition and analysis of data, writing the primary draft of this work and leading critical revisions to its content. KAP and RJV made substantial contributions to the design of the work, the acquisition and interpretation of data and critical revisions of its drafted content. All authors approve the final version submitted and are accountable for all aspects of the work and its integrity.

  • Funding This research was supported by an American Academy of Pediatrics Resident Research Grant.

  • Competing interests None declared.

  • Ethics approval Boston Medical Center Institutional Review Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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