Impact of Transport Team Simulations

Introduction: An estimated 250,000 children each year are transported between hospitals, with many of these transports performed by pediatric critical care transport teams (PCCTs). The makeup and education of these teams varies widely, and many are incorporating simulation into their training. The purpose of this study was to examine postsimulation debrief sessions to better understand how programs experience PCCT education using simulation. Methods: Twelve transport centers and a total of 78 transport teams nationwide participated in the multicenter Improving Pediatric Acute Care Through Simulation (ImPACTS) transport simulation study in which simulation was utilized to measure and compare PCCT performance. Each team went through 3 simulated cases followed by debriefing sessions. Qualitative analysis was conducted on 23 debriefing sessions from 6 centers. A thematic analysis approach using both inductive and deductive techniques was used to identify themes representing elements of practices, thoughts, and beliefs to better understand debriefing approaches used by facilitators and the content of debriefings. Results: We identified themes in 4 major categories: (1) debriefing process elements (advocacy inquiry, directive feedback, learner self-assessment, shared mental model, and addressing learning objectives); (2) latent safety threats (personnel or staffing, protocol, workspace or environment); (3) response to simulation; and (4) team dynamics. Debriefing process elements reflected how facilitators conducted debriefings, while the remaining categories reflected the content and insights generated during debriefings. Conclusions: Simulation participants found simulation to be realistic and a helpful tool to identify latent safety threats in their work. Simulation facilitators used consistent strategies to meet learning objectives and support learners in processing their simulation experience. Debriefing also provided insights to system-level vulnerabilities, suggesting a role for simulation not only in education, but also as a quality improvement tool.