Checklist use in evaluating pediatric disaster training

Authors

  • Rita V. Burke, PhD, MPH
  • Kathy Lehman-Huskamp, MD
  • Rachel E. Whitney, MD
  • Gitanjli Arora, MD, DTMH
  • Daniel B. Park, MD
  • Pamela Mar, MD
  • Mark X. Cicero, MD

DOI:

https://doi.org/10.5055/ajdm.2015.0210

Keywords:

checklist, disaster preparedness, disaster medicine, resident education, simulation

Abstract

Objective: Disaster preparedness training has a small but growing part in medical education. Various strategies have been used to simulate disaster scenarios to safely provide such training. However, a modality to compare their effectiveness is lacking. The authors propose the use of checklists, which have been a standard in aviation safety for decades.

Design: Residents at four different academic pediatric residency programs volunteered to participate in tabletop simulation of a timed, pediatric disaster scenario. Resident teams were required to properly triage and manage simulated patients. Care intervention requests corresponding to each of the patients were recorded on a premade checklist.

Results: Thirty-six teams provided a total of 1,476 possible care intervention requests for three pediatric patients: one with crush injury, one with increased intracranial pressure, and a nonverbal child. Some interventions were more likely to be omitted than others, and some teams performed extra interventions. Twenty-five entries from the checklist intervention responses were missing, affecting three of the teams. On average, teams requested 65 percent, were prompted to request 11 percent, and missed 22 percent of all checklist interventions with only 2 percent of all items not being recorded. Chi-square tests were performed for each patient scenario using R software. Categories compared included total counts of “requested,” “prompted,” and “missed” responses. Chi-square values were all statistically significant (p value < 0.05).

Conclusions: In the checklist use during a tabletop disaster simulation, the authors have demonstrated that the checklist allows trainees to receive near immediate feedback. This training exercise provided them an opportunity to explore their own preparedness for a disaster scenario in a low-stress environment and allows for evaluation of such preparedness in a safe environment.

Author Biographies

Rita V. Burke, PhD, MPH

Children's Hospital Los Angeles, Division of Pediatric Surgery, Keck School of Medicine, University of Southern California, California; Keck School of Medicine, University of Southern California, Los Angeles, California.

Kathy Lehman-Huskamp, MD

Department of Pediatrics, Medical University of South Carolina, South Carolina

Rachel E. Whitney, MD

Department of Pediatrics, Section of Emergency Medicine, Yale School of Medicine, Connecticut

Gitanjli Arora, MD, DTMH

Department of Pediatrics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California

Daniel B. Park, MD

Department of Pediatrics, Medical University of South Carolina, South Carolina

Pamela Mar, MD

Keck School of Medicine, University of Southern California, Los Angeles, California

Mark X. Cicero, MD

Department of Pediatrics, Section of Emergency Medicine, Yale School of Medicine, Connecticut

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Published

10/01/2015

How to Cite

Burke, PhD, MPH, R. V., K. Lehman-Huskamp, MD, R. E. Whitney, MD, G. Arora, MD, DTMH, D. B. Park, MD, P. Mar, MD, and M. X. Cicero, MD. “Checklist Use in Evaluating Pediatric Disaster Training”. American Journal of Disaster Medicine, vol. 10, no. 4, Oct. 2015, pp. 285-94, doi:10.5055/ajdm.2015.0210.

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