Council on Medical Student Education in Pediatrics


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COMSEP 2012 Indianapolis Meeting

Poster Presentation:

High Fidelity Simulation in the Pediatric Basic Clerkship: Respiratory Distress

Robert Dudas, MD - Johns Hopkins University; Michael Barone, MD MPH - Johns Hopkins University


Our department believes that all medical school graduates should be competent in recognizing respiratory distress and intervening until additional help arrives. This is consistent with national (COMSEP) curricular objectives which include: the ability to demonstrate the “ABC” assessment of a pediatric patient to determine who requires immediate medical attention/intervention. The purpose of this session is to help medical students develop an approach to assessing a pediatric patient in respiratory distress.


Objective(s) or goals

Students will demonstrate the “ABC” assessment as well as the initial emergency management of respiratory distress and airway obstruction in a child and develop an age-appropriate differential diagnosis 



Students were divided into groups of 4. Each group was asked to evaluate an infant (SimBaby) in respiratory distress in a simulated inpatient room with a faculty member portraying a nurse. Students then debriefed the scenario with their preceptor and discussed the differential diagnosis of respiratory decompensation while learning about proper positioning of the airway, supplemental oxygen delivery systems and bag-valve-mask ventilation. The simulation scenario is repeated in a “train to success” model.



One hundred twenty three students evaluated this module over a 1 year period (2010-2011). All groups repeated the simulation twice to demonstrate achievement of the objectives. All students rated the exercise highly with 96% strongly agreeing that they increased their skills and 97% strongly agreeing that this was educationally valuable.


This simulation technology has allowed us to customize the level of teaching appropriate to the level of our learners. Some groups were very comfortable in managing the ABCs and we were able to teach more advanced material such as oral and nasal airways. This methodology also allowed us to discuss the impact of age on normal and abnormal vital sign values in the context of acute illness.



As part of a series of structured educational workshops, we utilized high fidelity simulation to teach medical students an approach to pediatric respiratory distress. The workshop is highly rated by medical students. Future evaluation will measure correlation with our institutional comprehensive clinical skills examination