A Simulation Tools and Resources for Pediatrics
Medical simulation has been gaining momentum for the last 10-15 years. In the United States, simulation grew from the anesthesia programs and was based on crew resource management from the airline industry. Since then, nearly every medical specialty now requires simulation in residency training as well as medical school.

Some programs such as general surgery have nationally mandated simulation curricula in order to advance. The Accreditation Council for Graduate Medical Education (ACGME) mandates simulation in most residency programs — particularly those with procedural components.

Many resuscitation programs now mandate simulation as part of the training including NRP, PALS, ACLS, and ALSO. An entire industry of high-fidelity (and high-cost) medical simulators has been created by companies such as Laerdal, Limbs and Things, and Lifespan. The U.S. military has also incorporated high-fidelity simulation into the training of medics and nearly all of their residency programs. I have personally been involved in the creation of the family medicine simulation curriculum for more than 10 years. Finally, and without going into a literature review, the evidence has demonstrated definitively that simulation saves lives, reduces medical errors, and improves patient care.

We recently reviewed the HEEADSSS app developed in the U.K. and raved about the simple and effective interface and comprehensive supporting links and websites. The same author, James Edelman, working with the U.K. National Health Service (NHS) and the Pediatric Education, Innovation, and Research Network (PIER) has created a fantastic simulation app. The app is called STAR: Simulation Tools and Resources. The app brings a comprehensive pediatric simulation curriculum to smart devices for in-situ medical simulation. I haven’t seen anything like this before on a smartphone.

Evidence-based medicine

The STAR app collates numerous high-quality simulation scenarios on a wide variety of topics from across the U.K. Many of the scenarios include the national guidelines/protocols for specific scenarios (newborn resuscitation for example) used in the U.K. or other NHS materials. Other scenarios list specific references (some are included as supporting materials in PDFs). Certainly, the main concern with any app like this would be the need for scenario authors to periodically update their simulation scenarios based on new evidence/guidelines, etc.

What providers would benefit from this app?

Students, residents, mid-levels, pediatrics, primary care trainees, and educators/residency faculty. The app benefits anyone interested in pediatric medical simulation.

Price

o Free

Likes

o A pediatric simulation curriculum available in an app for your phone

o Excellent supporting materials that can be used for debriefing, further education

o Available for Android

Dislikes

o Resources limited to pediatrics

o Not much information in the scenarios for debriefing; not all scenarios in same format

o Needs faculty development section for “how” to perform in-situ simulation

Overall

The NHS, PIER and Edelman Systems has really knocked it out of the park with STAR. This is really an exciting app and a fantastic idea of how to collate simulation scenarios for in-situ medical simulation of pediatric trainees, multi-professional teams, etc. The app is constantly updated as new simulation materials are added by the PIER network and collaborators from the U.K.

Overall Score

o 5.0 stars.

User Interface

o 5.0 stars.

Easy to use with ability to sort by system, A-Z, folder creation, etc.

Multimedia Usage

o 4.5 stars.

The app is filled with documents describing the simulation scenario, videos, X-ray pictures, materials for debriefing, etc. App permits emailing resource materials to faculty/trainees.  

Price

o 5 stars.

App is free.

Real World Applicability

o 5.0 stars.

The STAR app is the most comprehensive simulation app that I have seen. As a big proponent for medical simulation, I strongly recommend this app to anyone who is interested in medical simulation–specifically pediatric simulation. Ideal for sim training in students, residents, junior faculty. Would love to see a similar app developed for adult medical simulation.

Device Used For Review

o iPhone 8 running iOS 12.2.     

Available for Download for iPhone, iPad, and Android.

Disclaimer: The views expressed are those of the author(s) and do not reflect the official policy of the Department of the Army, the Department of Defense or the U.S. Government.