Simulation Education in Emergency Medical Services for Children

Although medical simulation has been utilized for over 20 years, the field is still in its infancy in many ways. Ironically, by the mid-1970s, the expense associated with simulation education resulted in the dismantling and destruction of the simulation laboratory and the original medical simulator, Sim One [2]. Simulation remains an educational technique that is expensive and labor intensive, and its true value has yet to be realized.For the field to advance and to establish itself as a legitimate educational and research modality, an increase in the sophistication of the outcomes and impact of simulation will be required. It will be necessary to attract external research and development funding. The development of simulation-based competencies is an important milestone that is only beginning to be realized.The Accreditation Council on Graduate Medical Education has recently endorsed simulation as a training technique. A sentiment that has been echoed repeatedly is that “clinical skills should be learned as far away from the patient as possible” [40]. Ethical principles of respect for the patient “that the residents who have not done a given procedure do it for the first time away from patients whenever possible” are being voiced in the medical education community [40].Simulation can also be used to assess competencies in increasingly complex scenarios as learners progress through training. In Australia and New Zealand, the College of Anaesthetists has recently instituted a mandatory 2 1/2-day simulation-based course to assess competency in critical situations. This course is required of all anesthesia trainees before completion of their training. A similar initiative is in development by the Australian College of Emergency Medicine.The future of simulation depends on the adoption of simulation-based competencies at all levels of training and across multiple disciplines. The acceptance of simulation for training, competency assessment, remediation, human factors, and teamwork training and the development of external funding sources are keys for the future of medical simulation.The field of medical simulation is perhaps only slightly further along than Ed Link was in 1929 when he unveiled the first pilot trainer. The future of the field has been “imagined” by one of the pioneers of simulation, David Gaba. In Dr Gaba's vision, simulation has alternately flourished or met an untimely demise [3]. The actual outcome will depend, in large part, on the demonstration of value added through the use of simulation.     

The Little Program That Could: Saving Emergency Medical Services for Children

The experience of the federal Emergency Medical Services for Children program over the past 30 years illustrates many of the challenges facing those who advocate for programs that serve special populations or targeted purposes. Even programs that are well run and successful may find themselves targeted for budget cuts or elimination if they do not have committed champions, a readily identifiable constituency, and a range of resources at their disposal. The long campaign to preserve the Emergency Medical Services for Children program has yielded valuable lessons for advocates working at any level of government.     

Satisfaction With Care Coordination for Families of Children With Disabilities

Introduction

Children with disabilities have significant health care needs, and receipt of care coordinator services may reduce caregiver burdens. The present study assessed caregivers’ experience and satisfaction with care coordination.