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Development and validation of a generalizable tool
 to assess pediatric resuscitations




Yasaman Shayan and Arielle Levy
Pediatric Emergency Department
Sainte-Justine Hospital, Montreal, Canada
Background
‱ Resuscitation of a pediatric patient presents many challenges

‱ Competency in pediatric resuscitation skills gained by:
  ▫ Formal training (PALS)  Rapid decline in skills
  ▫ Experience  Rarity of pediatric cardiopulmonary arrest

‱ These points highlight the importance of simulation as an
  essential teaching tool
  ▫ Essential to have a valid and reliable assessment tool
Objectives
‱ To develop a short, objective, easy to use and
  generalizable scoring tool to assess trainees
  during simulated pediatric resuscitations
 ▫ To determine its validity
 ▫ To analyse its inter-rater reliability
Tool development

                                Content Validity
               Identification
                                    Review of
  AHA 2010       of specific
                                  scoring items
                  objective
     PALS       elements for
                                   by subject-
  curriculum                         matter
               each domain
                                     experts
                  (C-A-B)
Tool validation
‱ Convenience sample of residents rotating through ped ED

  First week             During the rotation             Last week

 5 video-taped               12-16 ER shifts            5 video-taped
   simulated                        +                     simulated
 resuscitation                 Simulation-              resuscitation
   scenarios                  based courses               scenarios




                  -   Asystole/PEA
    Scored        -   Arrhythmias                         Scored
                  -   Status epilepticus/ asthmaticus
                  -   Shock
Discussion
‱ What does the “perfect tool” look like to you?
 ▫ Checklist vs. Global Rating Scale
 ▫ Length

‱ Should we include crisis resource management
  skills (communication, leadership) in our tool?
 ▫ If so, how much weight should be allotted to CRM skills?

‱ Should we assess construct validity based on
  pre/post-rotation scores or pre/post-PALS course?

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Inspire levy shayan2010

  • 1. Development and validation of a generalizable tool to assess pediatric resuscitations Yasaman Shayan and Arielle Levy Pediatric Emergency Department Sainte-Justine Hospital, Montreal, Canada
  • 2. Background ‱ Resuscitation of a pediatric patient presents many challenges ‱ Competency in pediatric resuscitation skills gained by: ▫ Formal training (PALS)  Rapid decline in skills ▫ Experience  Rarity of pediatric cardiopulmonary arrest ‱ These points highlight the importance of simulation as an essential teaching tool ▫ Essential to have a valid and reliable assessment tool
  • 3. Objectives ‱ To develop a short, objective, easy to use and generalizable scoring tool to assess trainees during simulated pediatric resuscitations ▫ To determine its validity ▫ To analyse its inter-rater reliability
  • 4. Tool development Content Validity Identification Review of AHA 2010 of specific scoring items objective PALS elements for by subject- curriculum matter each domain experts (C-A-B)
  • 5. Tool validation ‱ Convenience sample of residents rotating through ped ED First week During the rotation Last week 5 video-taped 12-16 ER shifts 5 video-taped simulated + simulated resuscitation Simulation- resuscitation scenarios based courses scenarios - Asystole/PEA Scored - Arrhythmias Scored - Status epilepticus/ asthmaticus - Shock
  • 6. Discussion ‱ What does the “perfect tool” look like to you? ▫ Checklist vs. Global Rating Scale ▫ Length ‱ Should we include crisis resource management skills (communication, leadership) in our tool? ▫ If so, how much weight should be allotted to CRM skills? ‱ Should we assess construct validity based on pre/post-rotation scores or pre/post-PALS course?