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Enhancing paediatric resuscitation team performance: targeted simulation-based team leader training
  1. Ashley Keilman1,
  2. Jennifer Reid1,
  3. Anita Thomas1,
  4. Neil Uspal1,
  5. Kimberly Stone1,
  6. Elaine Beardsley2,
  7. Brian Burns3,
  8. Rebekah Burns1
  1. 1 Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA
  2. 2 Quality and Patient Safety, Children's Health Children's Medical Center Dallas, Dallas, Texas, USA
  3. 3 Emergency Medicine, Seattle Children's Hospital, Seattle, Washington, USA
  1. Correspondence to Dr Ashley Keilman, Pediatrics, University of Washington School of Medicine, Seattle, WA 98105, USA; ashley.keilman{at}


Effective team leadership is linked to improved resuscitation outcomes. Previous studies have focused primarily on trainee performance and simulation-based outcomes. We hypothesised that a targeted simulation-based educational intervention for experienced physicians focusing on specific process and communication goals would result in improved performance during actual resuscitations. We conducted an observational pilot study evaluating specific process metrics during clinical resuscitations before and after a 1-hour training intervention for paediatric emergency medicine (PEM) supervising physicians using rapid cycle deliberate practice simulation-based training. Videos of clinical resuscitations from before and after the intervention were retrospectively reviewed to assess time to patient transfer to emergency department stretcher, time to primary assessment and time to team leader summary statement. Between March and July 2018, 21/38 of PEM supervising physicians participated in a training session. After the intervention period, clinical resuscitation teams showed significant improvements in targeted process metrics: transfer of patient within 1 min (79% vs 100%, p=0.03), assessment completed within 3 min (28% vs 75%, p=0.01) and summary statement within 5 min (50% to 85%, p=0.03). Brief, focused simulation-based team leader training can improve the teamwork and communication performance of experienced clinicians during clinical resuscitations.

  • resuscitation
  • simulation
  • simulation for teamwork training
  • teamwork performance

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  • Presented at International Pediatric Simulation Symposia and Workshop 2019, Toronto, Canada.

  • Contributors This paper was developed by AK, JR, AT, KS, EB, NU, BB and RB. Each author made substantial contributions to each of the following: (1) conception and design of the study, or acquisition of data, or analysis and interpretation of data, (2) drafting the article or revising it critically for important intellectual content, and (3) final approval of the version to be submitted.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The study was reviewed and approved by the institutional review board.

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

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information. The data from this study are summarised in the table within the paper. Individual data points are protected by the institutional review board (IRB) and may not legally be shared per the terms of the IRB.

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