Initiation of a pediatric mock code program at a children's hospital

• Published in: Medical teacher Vol. 31; no. 6; pp. e241 - e247
• Main Authors: Tofil, Nancy M., Lee White, Marjorie, Manzella, Bryn, McGill, Denise, Zinkan, Lynn
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis 01.06.2009; Taylor & Francis Ltd
• Subjects: Adult; Cardiopulmonary resuscitation; Cardiopulmonary Resuscitation - education; Cardiovascular disease; Child; Child, Preschool; Children's hospitals; Clinical Competence; Codes; CPR; Data Collection; Educational Status; Female; Health education; Health professionals; Heart Arrest - prevention & control; Heart Arrest - therapy; Hospitals; Hospitals, Pediatric; Humans; Infant; Infant, Newborn; Internal Medicine; Internal Medicine - education; Internship and Residency - methods; Male; Medical residencies; Models, Educational; Paediatrics; Patient Care Team; Pediatrics; Pediatrics - education; Professional skills; Program Development; Respiratory Insufficiency - complications; Respiratory Insufficiency - therapy; Resuscitation; Self-Assessment; Simulation
• ISSN: 0142-159X; 1466-187X
• DOI: 10.1080/01421590802637974

Background: Pediatric cardiopulmonary arrests are rare. Mock codes were instituted to bridge the gap between opportunity and reality. Aim: The goal was to improve medical caregivers' skills in pediatric resuscitation. Methods: All pediatric and internal medicine/pediatric (med/peds) residents were anonymously surveyed pre- and post-intervention about confidence level about codes and code skills. Twenty mock codes were conducted during the 1 year intervention period. Statistical comparisons were made between each resident pre- and post-survey, graduating third-year residents (PGY3s) prior to intervention versus PGY3s with mock codes and pediatric versus med/peds residents. Results: All residents significantly improved in their perception of overall skill level during the study (p < 0.0001). PGY3s were significantly more confident in their skills than PGY2s or PGY1s and PGY2s were significantly more confident than PGY1s both pre- and post-mock codes (p < 0.0001). Med/peds residents were significantly more confident in their skills than pediatric residents both pre- (p = 0.041) and post-intervention (p = 0.016). The two skills with the lowest score post-intervention were the ability to place an interosseous line and the ability to manage cardiac dysrhythmias. Conclusions: Pediatric mock codes can improve resident confidence and self-assessment of their resuscitation skills. Data from surveys such as this can be used to design future skill-based educational initiatives.