Brannen, Melissa L, MD

Fugok, Kimberly L, DO

Kuntzman, Kaitlyn, DO

Rooney, Kris, MD

Vandenheuvel, Julia, MD

English

Lehigh Valley Health Network: LVHN Scholarly Works

Lehigh Valley Health Network LVHN Scholarly Works Posters Directed Simulation Intern Orientation Bootcamp Developed in Response to UME/GME COVID-19 Gap Analysis: A View from a Small Academic Community-Based Children’s Hospital Kaitlyn Kuntzman DO Julia Vandenheuvel MD Melissa L. Brannen MD Kimberly L. Fugok DO Kris Rooney MD Follow this and additional works at: https://scholarlyworks.lvhn.org/posters  Part of the Medicine and Health Sciences Commons This Article is brought to you for free and open access by LVHN Scholarly Works. It has been accepted for inclusion in LVHN Scholarly Works by an authorized administrator. For more information, please contact LibraryServices@lvhn.org. LVHN.org/children© 2021 Lehigh Valley Health NetworkConclusions•  There are varying perceptions of gaps caused by COVID-19•  Recognition of team dynamics, calling for help, and communicating areas of concern learned via simulation were unintended, but positive outcomes •  Majority identified improved communication skills, teamwork, and collaboration as key take-away learning moments•  Teamwork should be continuously discussed during simulation •  Continue to target orientation elements based on personalized, self-identified gaps and deficiencies to improve confidence in the management of several disease states and the entrustable professional activities of concernDirected Simulation Intern Orientation Bootcamp Developed in Response to UME/GME COVID-19 Gap Analysis: A View from a Small Academic Community-Based Children’s HospitalKaitlyn Kuntzman, DO, Julia Vandenheuvel, MD, Melissa Brannen, MD, Kimberly Fugok, DO, and Kris Rooney, MDDivision of Pediatrics and Pediatric Emergency Medicine, Lehigh Valley Reilly Children’s Hospital, Allentown, Pa.AbstractTraining experiences guide the gradual improvement in residents’ abilities to manage ill children. The COVID-19 pandemic has led to interrupted clinical training for medical students entering residency and has thus impacted clinical proficiency and self-perceived readiness for resident-level patient care responsibilities. In order to evaluate these gaps and perceived deficiencies, we collected survey data from the incoming pediatric residency class of 2024 at Lehigh Valley Reilly Children’s Hospital prior to their clinical start date. We designed a personalized, simulation-based, intern bootcamp orientation program aimed at closing the reported gaps and reinforcing foundational procedural skills.  We collected post-intervention survey data to determine if there was improved confidence and comfort with their new role, if educational gaps were addressed, and if improved procedural competence was met. The utility of a personalized intern bootcamp to assist in the transition from UME to GME training extends far beyond the COVID-19 pandemic and therefore will be added as an annual element of our program’s residency orientation.Research Questions and Hypothesis•  Evaluate the benefit of directed simulation bootcamp based upon pre-intervention survey  of self-identified gaps and deficiencies as a result of the COVID-19 pandemic•  Hypotheses:  1.  Interruptions in clinical training and deficiencies with regards to time spent in patient care roles would lead to lower confidence ratings in areas of procedural and patient care competencies 2.  The development and delivery of a deficiency-directed simulation workshop would lead to increased self-reported confidence in both procedural and patient care competencies as the transition to GME training occursreferences 1  Transition in a Time of Disruption. Practical Guidance to Support the Move from Undergraduate Medical Education to Graduate Medical Education. The American Association of Colleges of Osteopathic Medicine (AACOM), the Association of American Medical Colleges (AAMC), the Accreditation Council for Graduate Medical Education (ACGME), and the Educational Commission for Foreign Medical Graduates/Foundation for Advancement of International Medical Education and Research (ECFMG/FAIMER); 2021.2  Entrustable Professional Activities. EPA 1 for General Pediatrics. The American Board of Pediatrics. 2013. 3  Simulation Scenarios. Module. The American Academy of Pediatrics and the American College of Emergency Physicians. 2015. 4  TeamSTEPPS 2.0. Agency for Healthcare Research and Quality. June 2019. Accessed June 8, 2021. https://www.ahrq.gov/teamstepps/instructor/index.htmlResearch Design and Method•  The survey was developed from the guidance of the AAMC, ABP, AACOM, AAMC, ACGME, and ECFMG regarding transition from UME to GME training •  Bootcamp involved procedural skills, history taking techniques, differential diagnoses formulation, case lectures, practice with recognition of urgently or emergently ill children, building of interprofessional team dynamics,  order and prescription simulation, and developing the  IPASS method•  The bootcamp was designed using the AAP Simulation Scenario Module3 as well as PALS principles. Teamwork competencies using TEamSTEPPS® were also incorporated along with leadership activities4Figure 1: Pre-intervention gap assessment distributed to incoming interns (above).  Example of responses to the gap assessment for procedural competencies (below). Figure 3: Demonstrates improved confidence on post-intervention self assessment with identifying, managing, and educating about the six listed pediatric illness scripts.Figure 4: Demonstrates the most commonly identified ”take aways” from the directed simulation sessions.•  Pre-brief and debrief sessions •  Qualitative feedback and post-intervention survey  was providedResults•  83% of intern class responded to the post-intervention survey•  9 out of the 12 EPAs showed improved confidence rating  post-intervention•  All of the common pediatric illness scripts were covered in some part during the simulation•  All interns reported improved confidence with identifying and managing the six common pediatric illness scripts020406080100■PRE-INTERVENTION   ■POST-INTERVENTIONRecognize a patient requiring urgent or emergent care and initiate evaluation and managementObtain informed consent for testing and/or proceduresIdentify system failures and contribute to a culture of safety and improvementEducate patients on disease management, health promotion and preventative medicineGather an appropriate historyPerform a reliable physical examPrioritize a differential diagnosisRecommend and interpret common diagnostic and screening skillsEnter and discuss orders and prescriptionsDocument a clinical encounter in the patient recordProvide an oral presentation of a clinical encounterForm clinical questions and retrieve evidence to advance patient careGive or receive patient handover to transition care responsibilityCollaborate as a member of an inter-professional teamFigure 2: Demonstrates improved confidence on post-intervention self assessment with the 14 EPAs expected for incoming pediatric interns.percentage of interns confident to perform entrustable professional activities before and after intern bootcamppercentage of interns confident to address common pediatric illness presentations with indirect supervision before and after intern bootcamp020406080100■PRE-INTERVENTION   ■POST-INTERVENTIONDKA Septic Shock Status AsthmaticusStatus Epilepticus Respiratory DistressAMS

Directed Simulation Intern Orientation Bootcamp Developed in Response to UME/GME  COVID-19 Gap Analysis: A View from a Small Academic Community-Based Children’s Hospital

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Directed Simulation Intern Orientation Bootcamp Developed in Response to UME/GME COVID-19 Gap Analysis: A View from a Small Academic Community-Based Children’s Hospital

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