Abstract:
Background: Peer-assisted learning in pediatric simulation is effective in achieving competency. However, no studies were conducted in low-resource countries. PediSTARS has implemented a 3-level mentorship program for developing novice to expert faculty over the last 6 years. However, there is a paucity of mentors to facilitate this program across India. Hence, we implemented peer-assisted learning through WhatsApp (WA) and co-mentoring sessions over the last 3 years to facilitate the mentorship of novice simulation faculty as part of the Faculty Development Program (FDP).
Research Question: Does peer-assisted learning during the FDP improve the confidence of novice faculty to facilitate simulation at the workplace and bring about system change locally that can eventually improve patient care?
Methodology: FDP participants are added to a WA group 2 weeks before the course. PediSTARS senior mentors provide an overview of simulation, facilitating peer learning. Ice-breaking, simulation experiences, objectives, and resources available locally are discussed. Articles, pictures, and videos illustrating the concepts of simulation-based education are shared. Following the level-1 FDP-a 2-day program, each learner is allocated a mentor and co-mentor. The mentees complete the needs assessment, conduct about 6-8 simulation sessions in their institution, and reflect virtually with the mentors and co-mentors individually after each scenario over a 6-9-month period. Simulation research is part of the Level 3 FDP. During this time, learning happens through peer-to-peer interactions in the WA group. The co-mentors who are usually peers with 1-2 years seniority discuss with mentees and guide them with the simulation sessions before conducting the scenarios and are part of the mentor reflection sessions. A survey with 33 questions (Kirkpatrick – KP 1-4 evaluation) was conducted to study the impact of peer-assisted learning during the 3-year study period โ years 2021-2023. Descriptive statistics was applied and thematic analysis was conducted to evaluate the results.
Results: 40 qualified Level 3 FDP candidates were contacted via email and WA to complete the survey. The response rate was 90% (36/40). All (100%) were novices. 95% reported that peer learning from WA groups met training expectations, and 87% opined that learning was relevant, and engaging (KP-1). 100% reported peer learning enabled them to facilitate low-cost simulation scenarios and debriefing. 98% incorporated simulation-based education at the workplace (KP2). Following FDP, 94% felt more confident in managing real clinical emergencies and conducting and leading codes. 97% reported effective communication with families and inter-professional teams (KP 3). There were significant system changes at the bedside such as improvements in the clinical environment, equipment, teamwork, and display of cognitive aids. (Fig 1). Most importantly, the majority of the learners (89%) demonstrated improvement in real patient outcomes (Fig 2), especially in infection control and trauma care which contribute to major morbidity and mortality in low-resource countries. (KP 4)
Conclusions: The researchers demonstrated that peer-assisted learning is a very powerful, low-cost sustainable solution for faculty development programs in a low-resource country. This can be replicated easily in other countries. โ Nevertheless, the process requires dedicated mentors who are passionate and willing to provide personal time for community building.
Learning Objectives:
- Understand the strategies for peer-assisted learning to facilitate novice clinical simulation faculty to become proficient in a LMIC setup.
- Understand the impact of mentorship and Peer assisted learning for better patient outcomes.
- Customise in-situ simulation towards improving patient safety in their clinical settings.