Anaphylaxis Simulation Programs Can Improve Knowledge, Attitudes, and Behaviors (KAB) of Pediatric Residents
Sunday, March 6, 2016
South Exhibit Hall H (Convention Center)
Kiranjit K. Uppal, MD, Michelle Levinson, Susan Schuval, MD FAAAAI
Rationale: Anaphylaxis is a life-threatening medical condition requiring immediate treatment. Current physician training does not include adequate education regarding  anaphylaxis recognition and management. We hypothesized that an educational program including simulation training, in addition to a didactic presentation, would improve resident knowledge, attitudes, and behaviors (KAB) regarding anaphylaxis.

Methods: Pediatric residents at an academic medical center participated in a study of KAB regarding anaphylaxis. An anonymous questionnaire recorded participants’ demographic information, prior clinical experience and confidence with anaphylaxis. A 10-item pre-test was followed by a PowerPoint presentation and a hands-on demonstration of epinephrine autoinjectors.  Residents then participated in an anaphylaxis simulation, and completed a 10-item post-test.

Results: A total of 25 residents participated, including 11 PGY-1, 7 PGY-2, 5 PGY-3 and 2 PGY-4.  Fifteen of 25 residents (60%) reported prior clinical experience with anaphylaxis.  Prior to the educational intervention, 17 residents (68%) indicated confidence with anaphylaxis diagnosis, but only 9 residents (36%) felt confident with treatment of anaphylaxis. Mean pre-test scores (8.12 ± 1.72) were lower than mean post-test scores (9.20 ± .65), p <0.0062. During the simulation, all teams of residents were able to diagnose anaphylaxis and administer the correct dose of epinephrine in a timely manner.

Conclusions: Residents have limited exposure to anaphylaxis in the clinical setting, prompting the need for improved educational strategies, with the ultimate goal of improving patient outcomes.  An educational intervention that included anaphylaxis simulation and autoinjector demonstrations improved this knowledge gap.  Further study is warranted to determine whether this knowledge is retained over time.