Managing Emergencies in Pediatric Anesthesia (MEPA)
In August 2019, the 27th Annual Kenya Society of Anesthesiologists (KSA) and 7th Critical Care Society of Kenya (CCSK) conference held at Lake Naivasha Resort Kenya. The Centre for Medical Simulation and Patient Safety Kijabe hosted a cohort of 18 anesthesiologists and critical care physicians for a Managing Emergencies in Pediatric Anesthesia (MEPA) workshop, as part of the conference activities.
During this workshop, participants were taken through various scenarios in small groups and debriefing done thereafter. The state of the art technology at our simulation centre enables and interactive environment where one group does the scenario as the rest of the participants watch a live stream. This contributes a lot to constructive debriefing. Simulation training allows for learning in a controlled environment where it is safe to make mistakes. Participants took part in scenarios with real life challenges in a limited resource setting which include shortage of supplies, equipment malfunction, inability to make consultation in a timely manner, challenges in obtaining feedback such as laboratory results and total unavailability of resources or supplies.
In addition to clinical skills, these sessions also help improve non-technical skills that play a key role for successful outcomes. Teamwork, communication, leadership and role assignment among other non technical skills create a cohesive environment where a split of a second decision matters in a life or death in crisis. The more simulation scenarios we had, the more the participants engaged with the mannequin, treating it as a real patient. Success of simulation training lies in this capacity to ‘suspend disbelief’ and interact with the mannequin as one would a live patient. During debrief, some delegates shared real experiences similar to the scenarios they had gone through. At the end of the one-day course, 100% of the attendees agreed to the fact that this environment would contribute to safer outcomes and they recommend the same to be incorporated into training curriculums.
Challenges however remain with replicating this technology in other medical training institutions in limited resource setting with resource constraints being a major factor. However, with the effectiveness of medical simulation models in enhancing learner aspects that have proven through research to have contributed to safer outcomes. AIC Kijabe hospital through the Centre for Medical Simulation and Patient Safety is on the forefront in advancing medical simulation in the region. This center was established with funding from General Electric Foundation, and Marathon Oil with support from Vanderbilt University Medical Center and Assist International. It is equipped with three high fidelity mannequins i.e. SimMan, SimMom and SimBaby. The mannequins can be used for a range of training including pediatrics, obstetrics, anesthesia, and critical care among others.