A Simulation-Integrated Approach to Advancing Pediatric Emergency Preparedness in Morning Report Within Residency Training

Background Pediatric emergency care presents unique challenges, and emergency medicine (EM) residents often have limited exposure to high-risk pediatric emergencies and resuscitation. Traditional didactic methods may not fully bridge the gap between knowledge and clinical practice. With recent proposed revisions by the Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Emergency Medicine’s (ABEM) shift toward simulation-based assessment, practical pediatric training strategies have become increasingly essential. This study describes the design, implementation, and learner perceptions of a low-fidelity pediatric simulation curriculum, defined as the use of basic mannequins and case-based scenarios without advanced physiologic modeling, embedded within morning report. Integrating brief, low-fidelity pediatric simulations into morning report offers a scalable approach that provides repeated exposure while addressing barriers to traditional simulation, including limited space, scheduling constraints, and resource demands. Objective To describe and evaluate learner perceptions of an educational innovation integrating brief, low-fidelity pediatric simulation into EM residency morning report. Methods From September 2021 to May 2025, a four-year EM residency program incorporated 27 pediatric simulation sessions into weekly pediatric-focused morning reports. Morning report is a required, in-person, faculty-led, 30-minute daily case-based conference attended by residents, rotating learners, and faculty, with concurrent clinical coverage. Required resources were minimal, relying on existing conference time, low‑fidelity equipment, and faculty facilitation. Sessions used low-fidelity mannequins and a portable simulation setup, along with web-based or scripted case scenarios with evolving clinical data, followed by facilitated debriefing. Participants completed post-session surveys assessing perceived knowledge, comfort, and teamwork; agreement proportions were analyzed using binomial tests. Results Of 194 participants, 138 (71%) completed surveys. Respondents included EM residents (103, 75%), medical students (15, 11%), attending physicians (12, 9%), and other healthcare professionals (8, 5%). Most respondents selected “agree” on the Likert scale, reporting perceived improvement in pediatric knowledge (126, 91%), comfort (121, 88%), and teamwork (125, 91%). The proportion of participants reporting agreement for each outcome significantly exceeded a neutral (50%) distribution (all p < 0.001). Additionally, 126 respondents (91%) indicated “agree” when asked about the continued incorporation of pediatric simulation into morning reports. When asked whether they would recommend the sessions to a colleague using a five-point Likert scale, 110 respondents (80%) reported “strongly agree,” and 15 respondents (11%) reported “agree.” Conclusions Low-fidelity pediatric simulation embedded within morning report was feasible, well accepted, and associated with perceived improvements in knowledge, comfort, and teamwork. This scalable approach may enhance pediatric preparedness while aligning with evolving graduate medical education requirements.