Parry Center research and evaluation activities focus on building a knowledge base to foster improvements in education and healthcare in SD and the region.

Use of High Fidelity Simulation to Improve Medical Student Confidence and Knowledge of Pre-Arrest Pediatric Patient

Drs. Michelle Schimelpfenig, Jacqueline Berner, Benson Hsu, and Jody Huber, Sanford Children’s Hospital, have been studying a hypothesis of an increase in confidence and medical knowledge of third year medical students in their recognition and management of acutely ill children through the use of high fidelity simulation. Results show students felt more confident in caring for a pediatric patient (p-value = 0.00), talking with patients and families to gather information (p-value =0.02), communicating patient’s condition to senior team members (p-value = 0.01), recognizing an acutely ill and/or decompensating child (p-value = 0.00), and activating rapid response/code blue or calling for assistance (p-value = 0.00). Paired t-tests were conducted using STATA 11.2. Statistical significance set at p-values < 0.05. Knowledge tests have not shown significant increase following simulation. This may be secondary to debriefing sessions’ focus on teamwork, leadership and communication as opposed to illness specific medical knowledge.

Pediatric Resident “Boot Camp”

Spearheaded and organized by Dr. Stephen Messier (Staff Neonatologist) and Dr. Jody Huber (Pediatric Intensivist), the boot camp was supported by sixteen pediatric faculty members from the Sanford School of Medicine. Eighteen residents performed simulated medical procedures at the Parry Center to include endotracheal intubation, splinting of fractures, umbilical line placement, and many others. Residents also participated in one of four mock codes to help master the techniques they learned in the skill stations. Residents complete surveys based on their confidence with various procedures before and after the boot camp. These surveys demonstrated increased confidence in performing all procedures taught. On a scale of one to five, with one being no confidence and five being very confident, the greatest increase in mean confidence levels came after the needle thoracostomy station (1.7 to 3.4), chest tube station (1.3 to 3.0), and cardiac defibrillation station (2.3 to 3.6). On satisfaction surveys performed after the activity, the program earned high marks in effectiveness of teaching methods (4.88 out of 5), organization (4.82 out of 5), opportunity to participate (4.71 out of 5) and benefit to future career (4.88 out of 5). Faculty evaluations demonstrated an increased level of performance proficiency commiserate with the resident’s level of training.

The Use of Pediatric Urgent Assessment Simulation Scenarios to Increase Confidence and Competence of First Year Physician Assistant Students in Caring for Similar Patients During Their Future Clinical Rotational Experiences

Louise Papka, PA-C, MPAS, DFAAPA and Melissa Alexander, MSPAS, PA-C have been interested in demonstrating that hands-on, active, inquiry-driven learning experiences prepare first year Physician Assistant students to be more confident and feel more competent in handling similar situations with real life patients. As Physician Assistants are often on the front lines in rural medicine, it is essential for Physician Assistant students to be well trained in diagnosis, evaluation, treatment and management. Results demonstrate students felt more competent to manage patients with similar clinical presentations during their future clinical rotations experience, learned practical strategies that could be used in their clinical rotations educational experiences, were better able to scan the environment for important situational cues, developed skills in patient monitoring and changes in status, and had become more effective members of a healthcare team. Students also demonstrated improved communication, teamwork and critical thinking skills. The post-scenario debriefings allowed students to discuss solutions to challenges and problems encountered during the scenarios and fostered further learning.