Simulation Training for Pediatric Tracheostomy Emergencies Among Clinicians and Family Caregivers

Introduction: The 2025 ATS tracheostomy Clinical Practice Guideline recommends comprehensive emergency training for tracheostomy caregivers, yet standardized curricula and outcomes data remain limited. This study evaluates simulation-based training effectiveness.

Methods: Prospective cohort study at a quaternary pediatric center (2021-2024). Healthcare providers and family caregivers completed standardized simulation scenarios (mucus plugging, accidental decannulation, equipment failure) using actual home equipment. The primary outcome was pre-/and post-confidence change on a 5-point Likert scale. Secondary outcomes included satisfaction and between-group comparisons.

Results: Among 522 participants (272 providers, 250 caregivers), both groups demonstrated significant improvement. Providers improved from 3.63±1.19 to 4.27±0.95 (p < 0.001, d=0.59); caregivers from 3.47±0.88 to 4.12±0.93 (p < 0.001, d=0.74). The magnitude of improvement did not differ between groups (p=0.82). Among low-baseline participants, 85-86% improved regardless of cohort. Satisfaction exceeded 98% in both groups.

Conclusions: Simulation training significantly improves confidence equivalently among providers and caregivers, supporting a unified curriculum for ATS guideline implementation. Limitations include the use of confidence as a surrogate measure and ceiling effects among experienced participants.