PEM FITNESS: A Faculty Skills-Maintenance Simulation Curriculum for Pediatric Emergency Medicine

Pediatric emergency medicine (PEM) requires proficiency in high-acuity, low-occurence (HALO) procedures. Opportunities for faculty to perform such procedures decline after training, leading to attrition of skills and confidence that can affect bedside teaching and patient safety. There is currently no standard mechanism for maintenance of skills for PEM faculty. Utilizing a previously conducted needs assessment, we sought to design, implement, and evaluate the PEM Faculty Interactive Training on Necessary Emergency Skills & Simulation (PEM FITNESS) curriculum.

Based on prior needs assessment, the curriculum targeted high-value procedures (e.g., video laryngoscopy, thoracostomy, cricothyrotomy). It ran 7 sessions over two years, with small-group, hands-on stations using simulation models/manikins, led by PEM and content-expert faculty (EM, ultrasound, surgery/trauma). Pre-learning was sent one week prior. Pre-, post-, and 6-month REDCap Likert surveys assessed recent performance/supervision of HALO procedures, self-reported confidence, curriculum effectiveness, and feedback.

Faculty participation was 100% in both years (24/24; 26/26). Pre-survey results indicated that faculty performed or supervised most HALO procedures at least once in the prior year (except cardiac pacing and jet insufflation), with supervision more common than performance. Procedural confidence increased and was sustained at 6 months, with the most notable increases in airway skills confidence. All faculty endorsed the importance of maintaining procedural skills; 74% reported personal skill attrition, and 96% agreed faculty should demonstrate competence for credentialed procedures.

A faculty-targeted, simulation-based PEM curriculum achieved universal engagement and sustained confidence, especially for airway skills, demonstrating feasibility to mitigate procedural skills attrition among PEM faculty. Future work will iteratively refine, scale, and disseminate the curriculum and study its impact on procedure success.