Development and Optimization of a Remote Pediatric Cardiac Critical Care Bootcamp Using Telesimulation

Objectives: We developed a novel cardiac critical care bootcamp consisting of didactic, small-group and simulation sessions. The bootcamp was remote due to the COVID-19 pandemic and included telesimulation. We aimed to assess learners’ reactions to the bootcamp and their perception of telesimulation. Methods: Paired anonymous surveys were administered before and after participation. Surveys assessed participants’ comfort in independently managing cardiac critical care scenarios, perceptions of telesimulation, barriers to its effectiveness, and specific feedback on course components. Results: Forty-three fellows from 10 institutions joined the bootcamp over two years. 38 pre- and 28 post-course surveys were completed. The course was rated good or excellent by all respondents, and 27/28 rated the material as appropriate to their level of training. Based on feedback from 2020, the electrophysiology sessions were converted to a small group format in 2021; positive assessment of these sessions improved from 65% to 90-100%. The telesimulations were highly rated, with 83-94% of participants in 2020 and 90-100% in 2021 rating them as good or excellent. Participants’ views on telesimulation improved following the course, with 78% (14/18) post- versus 50% pre-participation agreeing that telesimulation is an effective educational tool (p=0.06) and 56% (10/18) post- versus 67% (12/18) pre- rating telesimulation as less effective than in-person simulation (p=0.04). Identified limitations of telesimulation were limited active participation, lack of realism, impaired flow of conversation, and audiovisual and technical concerns. Conclusions: Telesimulation is feasible in cardiac critical care education, and was an acceptable alternative to in-person simulation for course participants.