Written by Elizabeth Sanseau, MD, MS, DTM&H, FAAP; Anita A. Thomas, MD, MPH, FAAP, FACEP; and Marc Auerbach, MD
Let’s face it: pediatric emergencies are different. They’re high-stakes, high stress, and often unpredictable. Pediatric patients may be small but can be complex. Simulation offers a powerful tool to improve outcomes, build confident teams, and reveal cracks in systems before real patients “fall through them.” Whether you’re new to sim or looking to level up your program, here are Three Truths, Three Pitfalls, and Three Must-Know Facts about pediatric simulation.
Three Truths
1. Many kids need a different kind of care than adults: frequent pediatric emergency training is needed.
Kids are not just little adults. Their vital signs, medication doses, and emotional needs are totally different. Throw in the stress of family-centered care and/or children with chronic conditions, and you’ve got a complex scenario that demands teamwork and precision. Simulation allows us to rehearse those nuances before it’s game time. Simulations should be done frequently and can use resources like SimBox ED when a sim center is not available (such as nights, weekends, or low-resource settings).
2. Simulation exposes the stuff you didn’t know was broken – it’s not just for teaching novices.
Ever gone to grab a medication and found it locked in the wrong drawer? Or realized the neonatal bag-valve-mask isn’t actually on the airway cart? In-situ simulation helps uncover these latent safety threats that may be missed on a standard checklist or hospital policy. Sim allows us to debug the system in a safe, controlled setting to optimize pediatric care.
3. Learning happens in a psychologically safe space with a trusted facilitator.
People don’t learn well in a panic or when they are afraid of being judged. The best sims are built on trust and vulnerability – where it’s okay to mess up, speak up, and reflect – so real clinical growth and change can happen. Frequent simulations allow learners and facilitators to trust one another.
Three Common Pitfalls (And How to Avoid Them)
1. Sim is used only for rare events.
Sure, code blues matter, but what about practicing everyday challenges – like safe discharge planning, verbal de-escalation of an agitated patient, or trauma-informed communication with teens? Running frequent, low-dose simulation for “mundane” moments may have the biggest payoff in quality and safety.
2. Getting too caught up in the bells & whistles.
High-end manikins are cool, but they’re not always necessary – chasing realism without good design defeats the purpose of improved pediatric outcomes. A well-designed scenario with a laminated card can sometimes have a bigger impact than a $10,000 high-fidelity simulator collecting dust. Resources like SimBox ED and case banks like EMRescuPeds can allow you to sim whenever and wherever you want.
3. Leaving key team members out of the room.
Simulation is strongest when everyone is in the room. That means nurses, techs, EMS, security, and even families. If your sim excludes the people who show up in real emergencies, it’s not truly preparing your team. Real emergencies involve the entire team. Your sim training should too.
Three Must-Know Facts
1. Sim saves lives – literally.
This isn’t theory. Studies show that in-situ sim-based training initiatives are associated with reduced mortality rates. Sim also reduces med errors, improves CPR quality, and speeds up the time critical interventions in real pediatric emergencies. Simulation practice improves participants knowledge/skills but also patient-level outcomes.
2. Cross-team sim breaks down silos.
When EMS trains with ED. When OB huddles with NICU. When med students learn from nurses. Simulation isn’t just skill-building – it’s culture-shifting. Simulation fosters collaboration and mutual respect in ways that meetings or emails cannot.
3. You don’t need big money to make a big impact.
Some of the most effective simulations are built with paper dolls, cardboard monitors, and homemade scenarios. Don’t let a small budget stop you. The secret isn’t the gear – it’s the intention.
Bottom Line:
Pediatric simulation isn’t optional; it’s vital for anyone who cares for ill or injured infants and children. When it’s done intentionally, with the right people and purpose, it becomes more than just a drill – it becomes a safety net for kids, a growth space for teams, and a catalyst for real change.
So go ahead, run a pediatric scenario. It might stress you out and take some work – but it also just might SAVE A LIFE!
This post was jointly written by Elizabeth Sanseau, MD, MS, DTM&H, FAAP; Anita A. Thomas, MD, MPH, FAAP, FACEP; and Marc Auerbach, MD
