Researchers at Children’s Hospital of Philadelphia (CHOP) found that a tele‑simulation program for pediatric emergency staff at Komfo Anokye Teaching Hospital in Kumasi, Ghana, was associated with a large decrease in inpatient hospital deaths among children with suspected sepsis. The research was recently reported in the journal Pediatric Critical Care Medicine.
Hospitals in low‑resource settings often lack regular, practical emergency training, and in‑person simulation is costly and limited by low internet bandwidth and staff time. Driven by a promising pilot project and local concern over high pediatric sepsis deaths, the researchers tested a low‑bandwidth, culturally adapted remote simulation to see if an efficient, affordable program could help frontline clinicians better recognize and treat children with sepsis and reduce deaths.
From Sept. 2023 to Sept. 2024, researchers compared care six months before and six months after staff completed two 30‑minute tele‑simulation sessions and structured debriefings. They found that in‑hospital mortality fell from 35.7% to 10.4% among children aged 2 months to 14 years screened for suspected sepsis or septic shock. The low‑bandwidth intervention used locally filmed patient videos and a standardized debrief so it could run reliably in a resource‑limited setting.
Forty‑five frontline clinicians completed the sessions. Of those participants, provider responses were strongly positive: nearly all trainees rated the tele‑simulation as acceptable, feasible, and easy-to-use. Additionally, simulation task performance improved between sessions.
While the single-site, before-and-after study with a small patient sample has limitations, the study’s authors are encouraged by these early results. They call for larger, controlled multi‑center trials with improved severity measures, tracking of downstream therapies, and longer follow‑up to determine if the training itself produced the benefit and positive outcomes persist.
“While further research is needed, the model is low‑cost, adaptable, and potentially scalable to other low‑resource hospitals where internet bandwidth and clinical training resources are limited,” said Vanessa C. Denny, MD, MS, the study’s lead author and an attending physician in the Division of Critical Care Medicine.
The authors received funding from the University of Pennsylvania Holman Africa Research and Engagement, CHOP’s Children’s Anesthesia Associates Education Innovation, the CHOP Center for Leadership and Innovation in Medical Education, the CHOP Global Scientific Excellence Award, the CHOP Center for Leadership and Innovation in Medical Education, the CHOP Global Scientific Excellence Award, the German Federal Ministry for Research and the National Institutes of Health (NIH).
Denny et al. “Pediatric Emergency Department Care for Septic Shock in Sub-Saharan Africa: Single-Center Outcomes Before-versus-After Implementation of a Tele-Simulation Program, 2023-2024.” J Pediatr Crit Care Med. Online DATE TK
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Researchers at Children’s Hospital of Philadelphia (CHOP) found that a tele‑simulation program for pediatric emergency staff at Komfo Anokye Teaching Hospital in Kumasi, Ghana, was associated with a large decrease in inpatient hospital deaths among children with suspected sepsis. The research was recently reported in the journal Pediatric Critical Care Medicine.
Hospitals in low‑resource settings often lack regular, practical emergency training, and in‑person simulation is costly and limited by low internet bandwidth and staff time. Driven by a promising pilot project and local concern over high pediatric sepsis deaths, the researchers tested a low‑bandwidth, culturally adapted remote simulation to see if an efficient, affordable program could help frontline clinicians better recognize and treat children with sepsis and reduce deaths.
From Sept. 2023 to Sept. 2024, researchers compared care six months before and six months after staff completed two 30‑minute tele‑simulation sessions and structured debriefings. They found that in‑hospital mortality fell from 35.7% to 10.4% among children aged 2 months to 14 years screened for suspected sepsis or septic shock. The low‑bandwidth intervention used locally filmed patient videos and a standardized debrief so it could run reliably in a resource‑limited setting.
Forty‑five frontline clinicians completed the sessions. Of those participants, provider responses were strongly positive: nearly all trainees rated the tele‑simulation as acceptable, feasible, and easy-to-use. Additionally, simulation task performance improved between sessions.
While the single-site, before-and-after study with a small patient sample has limitations, the study’s authors are encouraged by these early results. They call for larger, controlled multi‑center trials with improved severity measures, tracking of downstream therapies, and longer follow‑up to determine if the training itself produced the benefit and positive outcomes persist.
“While further research is needed, the model is low‑cost, adaptable, and potentially scalable to other low‑resource hospitals where internet bandwidth and clinical training resources are limited,” said Vanessa C. Denny, MD, MS, the study’s lead author and an attending physician in the Division of Critical Care Medicine.
The authors received funding from the University of Pennsylvania Holman Africa Research and Engagement, CHOP’s Children’s Anesthesia Associates Education Innovation, the CHOP Center for Leadership and Innovation in Medical Education, the CHOP Global Scientific Excellence Award, the CHOP Center for Leadership and Innovation in Medical Education, the CHOP Global Scientific Excellence Award, the German Federal Ministry for Research and the National Institutes of Health (NIH).
Denny et al. “Pediatric Emergency Department Care for Septic Shock in Sub-Saharan Africa: Single-Center Outcomes Before-versus-After Implementation of a Tele-Simulation Program, 2023-2024.” J Pediatr Crit Care Med. Online DATE TK
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