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Improved Team Performance During Pediatric Resuscitations After Rapid Cycle Deliberate Practice Compared With Traditional Debriefing

A Pilot Study

Lemke, Daniel S. MD; Fielder, Elaine K. MD; Hsu, Deborah C. MD, MEd; Doughty, Cara B. MD, MEd

doi: 10.1097/PEC.0000000000000940
Original Articles

Introduction Simulation-based medical education (SBME) improves medical knowledge compared with no intervention. In traditional SBME, more time is spent debriefing than practicing skills. Rapid cycle deliberate practice (RCDP) simulation allows learners to practice skills repetitively, receive brief interspersed feedback, and has been shown to improve individual performance of resuscitation skills in simulation; it has not been compared with traditional simulation methods.

Objective The aim of the study was to compare traditional and RCDP SBME.

Methods Four pediatric resuscitation cases (3 for teaching and 1 for testing) were developed. For the RCDP arm, traditional cases were deconstructed into sequences of progressively difficult rounds. The last RCDP round served as the traditional arm scenario.

Learners received 1 type of instruction on 2 separate days. Pretest and posttest performance during simulation were video recorded and scored using the Simulation Team Assessment Tool; satisfaction surveys were collected.

Results Pretest team performance was similar in both groups. Simulation Team Assessment Tool score improvement for RCDP was 7.2% (95% confidence interval, 3.4% to 11%) and traditional was 0.8% (95% confidence interval, −11% to 13%). The difference in improvement of the human factors subscore was statistically significant; RCDP improved 10.2% and traditional improved 1.7% (P = 0.013). The RCDP technique was well received by learners but caused fatigue.

Conclusions This pilot study showed a trend toward greater improvement in team performance and significantly greater improvement for human factors with RCDP compared with traditional simulation. Future studies comparing RCDP with other methods are needed to identify best practices and applications of RCDP, including which learners and learning objectives are best suited to RCDP.

From the Department of Pediatrics, Section of Emergency Medicine, Baylor College of Medicine, Houston, TX.

Disclosure: The authors declare no conflict of interest.

Reprints: Daniel S. Lemke, MD, Section of Emergency Medicine, Department of Pediatrics, Baylor College of Medicine/Texas Children's Hospital, 6621 Fannin St, Ste. A2210, Houston, TX 77030 (e-mail:

Supported by internal educational grant from Texas Children's Hospital, Houston, Texas.

Presented at the International Pediatric Simulation Symposia and Workshops, 2014 Vienna, Austria, April 24, 2014, as roundtable discussion.

Online date: October 13, 2016

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