P3.229: Mastering Pediatric Airway Skills: A Procedural Simulation Using Rapid Cycle Deliberate Practice for Emergency Medicine Residents.

Background: Advanced pediatric airway management is an essential skill in emergency medicine (EM). The infrequent occurrence of pediatric intubations and variations in preceptor training can make it challenging for residents to develop competency and confidence. A pilot longitudinal curriculum was developed to address this, supported by the SAEMF/Simulation Academy Novice Research Grant. This curriculum incorporates multimodal teaching strategies, including a flipped classroom format and Rapid Cycle Deliberate Practice (RCDP). RCDP, a simulation-based instructional approach, allows learners to repeatedly perform procedures with immediate micro-debriefs and feedback, promoting continuous improvement. This study aims to evaluate the impact of this procedural simulation curriculum on EM residents’ confidence, knowledge, and competency in pediatric airway management.

Methods: Between July and December 2024, residents of all training levels from a four-year academic EM residency participated in a procedural simulation curriculum designed to master pediatric airway techniques, not only including equipment setup and intubation, but also the ability to troubleshoot bag-valve mask (BVM) ventilation problems. Residents received individualized feedback from rater-calibrated Pediatric Emergency Medicine (PEM) and EM facilitators using the RCDP approach. Pre- and post-intervention assessments, including simulated procedural performance, were measured with skills checklists and self-reported procedural competency surveys. Data were analyzed using the Wilcoxon rank-sum test.

Results: Twenty-eight residents completed baseline procedural assessments and participated in the RCDP simulation sessions. Pre- and post-intervention self-reported procedural competency surveys were completed by 27 residents. Analysis showed a statistically significant increase in residents' self-perceived airway procedural competency across all four class years (p < 0.01). After curriculum implementation, all residents demonstrated statistically significant improvement in completing checklist items related to equipment setup and intubation techniques (p < 0.05). However, no such improvements were observed in troubleshooting BVM ventilation issues.

Conclusion: Pediatric airway management is a low frequency, high-risk event. Completing this novel procedural simulation curriculum utilizing RCDP demonstrated increased EM residents’ simulated procedural performance and self-reported procedural competency.