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Meeting ReportEditors' Choice

Utilizing Competence-Based Simulation to Improve Orientation Outcomes

Honey Lee Pezzimenti, Patricia Achuff, Roberta Hales, Cheryl Dominick, Maureen Ginda, Akira Nishisaki and Natalie Napolitano
Respiratory Care October 2021, 66 (Suppl 10) 3606965;
Honey Lee Pezzimenti
Department of Respiratory Care, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
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Patricia Achuff
Department of Respiratory Care, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
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Roberta Hales
Center for Simulation, Advanced Education & Innovation, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
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Cheryl Dominick
Department of Respiratory Care, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
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Maureen Ginda
Department of Respiratory Care, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
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Akira Nishisaki
Anesthesiology, Critical Care Medicine, and Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States
Center for Simulation, Advanced Education & Innovation, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
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Natalie Napolitano
Department of Respiratory Care, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
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Abstract

Background: New graduate respiratory therapists (NG), regardless of degree program, receive limited preparation in neonatal/pediatric diseases and management. Experienced therapists (Exp) typically have adult knowledge, but limited exposure to pediatrics. We implemented a competence-based simulation program to help improve successful completion of orientation.

Methods: A 9-week orientation program curriculum with simulation-based competence assessment was developed to assure all new hires gain foundational knowledge and skills to perform pediatric clinical tasks. Each new hire individually completed the same simulation scenarios during the first week (pre) and last week of orientation (post). Curriculum changes were made based on the performance in the simulations as well as their on-the-job training knowledge and skills during and after orientation. The scoring system changed at the time of curriculum update (between period 1 and 2). Paired and unpaired t-tests with P < 0.05 as significant. Exemption was granted from local IRB.

Results: From Jan 2017–Feb 2020, the program had two curriculum updates (Period 1-3). Period 2 introduced weighted checklists for both simulations and Period 3 introduced 7 weekly didactic sessions. Noninvasive ventilation and decompensating patient scenarios were completed for all periods. Ninety-three new staff were oriented [period 1 = 29 (NG 20, Exp 9); period 2 = 42 (NG 31, Exp 11), period 3 = 22 (NG 22)]. Mitigation during orientation occurred in 16% of the staff. 67% successfully advanced on to ICU orientation after completion of the program. All staff improved scores between pre vs. post simulations in all periods: mean difference ± standard deviation [Period 1: NG 32.1 ± 17.0 P < 0.001; Exp 28.1 ± 18.9, P < 0.001; Period 2: NG 27.2 ± 19.9, P < 0.001; Exp 28.8 ± 12.8, P < 0.001; Period 3: NG 19.6 ± 14.5,P < 0.001, paired t-test]. The scores between NG and Exp during post-simulation were not significantly different for Period 1 (P = 0.346), however was significantly different for Period 2 and 3 (P = 0.040, unpaired t-test).

Conclusions: Use of a competence-based orientation program effectively shows educational advancements from orientation and assists with analysis of readiness for orientation completion.

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Footnotes

  • Commercial Relationships: Natalie Napolitano has research/consulting relationships with Philips, Smiths Medical, Drager, VERO-Biotech. All other authors have no disclosures.

  • Copyright © 2021 by Daedalus Enterprises
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Respiratory Care
Vol. 66, Issue Suppl 10
1 Oct 2021
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Utilizing Competence-Based Simulation to Improve Orientation Outcomes
Honey Lee Pezzimenti, Patricia Achuff, Roberta Hales, Cheryl Dominick, Maureen Ginda, Akira Nishisaki, Natalie Napolitano
Respiratory Care Oct 2021, 66 (Suppl 10) 3606965;

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Utilizing Competence-Based Simulation to Improve Orientation Outcomes
Honey Lee Pezzimenti, Patricia Achuff, Roberta Hales, Cheryl Dominick, Maureen Ginda, Akira Nishisaki, Natalie Napolitano
Respiratory Care Oct 2021, 66 (Suppl 10) 3606965;
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