Dr. Marjorie White (U Alabama)

1. INSPIRE Procedures Working
Group:
Development of a Standardized Process for INSPIRE
Procedure Kits
Marjorie Lee White MD, MPPM
Children’s of Alabama/University of Alabama at Birmingham
IMSH 2013: Orlando, Florida / USA
International Network for Simulation-based Pediatric Innovation, Research and Education

2. Background
• Pediatric Emergency Medicine program directors have approached
INSPIRE leadership for assistance with teaching procedures.
• Individually (IO, CVL) and in research groups (LP), INSPIRE members
are active in developing expertise in the development of resources to
address procedural competency.
• Informal groups of pediatric simulation experts (PEM, NICU,
Hospitalists) have met at national meetings i.e. IMSH 2012, PAS 2012,
AAP 2012 to start this work.
International Network for Simulation-based Pediatric Innovation, Research and Education

3. PICO Question
• P: pediatric procedural training and assessment is highly variable
• I: develop standardized components and process for development of
INSPIRE approved procedural training kits
• C: current procedural training and assessment
• O: Primary: improved procedural competence of trainees and
teaching by faculty; Secondary: meet needs of program directors
International Network for Simulation-based Pediatric Innovation, Research and Education

4. Approach / Design
• Develop common resources
– Procedural competency overview
– How to teach procedures with simulation/ deliberate practice
– How to use a checklist
– Formative and summative evaluation
• Develop procedure level specific process that results in an INSPIRE
“Kit” to include:
a. Validated checklist
b. Learner resources
i. Video/handouts
c. Teaching resources
i. Information about task trainers/ Supply lists
ii. Knowledge-based questions
iii.Simulation scenarios to embed training in
International Network for Simulation-based Pediatric Innovation, Research and Education

5. Suggested Procedure Process
1. Identify all current resources available
2. Adapt/Develop checklist
Develop checklist
Distribute to INSPIRE procedure subgroup for review using “How to evaluate a
checklist ppt”
Make videos of learners performing task using checklist
Distribute via video portal to look at issues of inter-rater reliability etc.
3. Adapt/Develop video resources
How to do procedure
How to teach procedure
4. Adapt/Develop INSPIRE procedure kit
Learner resources
Teaching resources –
5. Test INSPIRE procedure kit – to move towards summative evaluation
6. Publish-- Research about process AND INSPIRE procedure kits to MedEdPortal
7. Continuous improvement-- Biannually? – review INSPIRE kit for necessary updates

6. Procedures
Pediatric Resident Pediatric EM Fellow
• Bag-mask ventilation • Cricothyrotomy
• Neonatal endotracheal intubation
• Umbilical catheter placement
• Central venous catheter placement
• Lumbar puncture • Tube thoracostomy
• Venipuncture • Umbilical vessel catheterization
• Peripheral IV placement
• Bladder catheterization
• Vaginal delivery
• IO
• Simple removal of foreign body • Endotracheal intubation/Supraglottic
• Incision and drainage of abscess airway devices
• Temporary splinting of fracture
• Reduction of simple dislocation • Cardioversion/Defibrillation/Pacing
• Simple laceration repair • Perciardiocentesis
• Giving immunizations • Lumbar puncture

7. 3 Questions to improve study
1. What psychometric resources are available within
INSPIRE to improve rigor of process?
2. How can this project best be organized and
facilitated?
3. Is it feasible?
International Network for Simulation-based Pediatric Innovation, Research and Education

8. People already involved
Marc Auerbach Taylor Sawyer
Todd Chang Tom Gratton-Smith
David Kessler Renee Pyburn
Josh Nagler Elizabeth Vukin
Gary Geis Akshaya Vachharajani
Elaine Feilder Pavan Zaveri
Daniel Lemke Cara Doughty
DJ Scherzer Noel Zuckerbraun
Rebecca Hamilton Nirali Patel
Tonya Thompson Mary Patterson
Joel Clingenpeel
Joseph Dobson
Renuka Mehta
Denis Orio
Eric Reichman

9. Contact Information
Name: Marjorie Lee White MD, MPPM, MEd
Institution: UAB/Children’s of Alabama
E-mail, Phone: mlwhite@peds.uab.edu,
205-638-9587
International Network for Simulation-based Pediatric Innovation, Research and Education