{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T12:45:06Z","timestamp":1791895506740,"version":"4.3.4"},"reference-count":12,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,3,27]],"date-time":"2024-03-27T00:00:00Z","timestamp":1711497600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,3,27]],"date-time":"2024-03-27T00:00:00Z","timestamp":1711497600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Med Educ"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Diabetic ketoacidosis (DKA) is a frequent manifestation at the onset of type 1 diabetes mellitus in children, possibly associated with a wide range of complications, often as a consequence of wrong or delayed treatment. Due to its complex and risky management, direct exposure to real situations alone is not sufficient to achieve adequate skills in pediatric DKA for residents. Simulation could be a valuable aid, allowing to practice a standardized scenario of a complex real-world situation. We aimed to test the effectiveness of a standardized scenario of pediatric DKA in teaching its recognition and treatment.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We develop a standardized scenario able to guide step-by-step the learners through the flowchart of DKA management and considering alternative evolutions in the case of possible deviations from guidelines. It was a real-life simulation with the use of a high-fidelity pediatric simulator. It was played by 78 pediatrics 20 and emergency medicine residents. At the end of the simulation, a validated questionnaire was administered to collect feedback from participants regarding the impact of the simulation on learning. All materials to reproduce the DKA scenario are provided.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Overall, the scenario was rated as realistic (mean score 4.37\u2009\u00b1\u20090.68, from 1 to 5) and relevant to professional training (4.72\u2009\u00b1\u20090.47), useful in increasing confidence in interpreting laboratory tests (3.97\u2009\u00b1\u20090.65), group organization and communication strategies (3.49\u2009\u00b1\u20090.94), and managing the treatment of DKA (3.46\u2009\u00b1\u20090.92).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The use of a standardized scenario of pediatric DKA may be a valid tool to reinforce theoretical knowledge in residents, both in pediatrics and in emergency medicine, and to directly and safely practice pediatric DKA management.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12909-024-05334-0","type":"journal-article","created":{"date-parts":[[2024,3,27]],"date-time":"2024-03-27T17:03:21Z","timestamp":1711559001000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Effectiveness of a standardized scenario in teaching the management of pediatric diabetic ketoacidosis (DKA) to residents: a simulation cross-sectional study"],"prefix":"10.1186","volume":"24","author":[{"given":"Alice","family":"Monzani","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Corti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Scalogna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Savastio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica","family":"Pozzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pier Paolo","family":"Sainaghi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco Della","family":"Corte","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivana","family":"Rabbone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,3,27]]},"reference":[{"key":"5334_CR1","doi-asserted-by":"publisher","first-page":"17016","DOI":"10.1038\/nrdp.2017.16","volume":"3","author":"A Katsarou","year":"2017","unstructured":"Katsarou A, Gudbj\u00f6rnsdottir S, Rawshani A, Dabelea D, Bonifacio E, Anderson BJ, Jacobsen LM, Schatz DA, Lernmark \u00c5. Type 1 diabetes mellitus. Nat Rev Dis Primers. 2017;3:17016. https:\/\/doi.org\/10.1038\/nrdp.2017.16.","journal-title":"Nat Rev Dis Primers"},{"issue":"1","key":"5334_CR2","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1038\/s41572-020-0165-1","volume":"6","author":"KK Dhatariya","year":"2020","unstructured":"Dhatariya KK, Glaser NS, Codner E, Umpierrez GE. Diabetic ketoacidosis. Nat Rev Dis Primers. 2020;6(1):40. https:\/\/doi.org\/10.1038\/s41572-020-0165-1.","journal-title":"Nat Rev Dis Primers"},{"issue":"7","key":"5334_CR3","doi-asserted-by":"publisher","first-page":"835","DOI":"10.1111\/pedi.13406","volume":"23","author":"N Glaser","year":"2022","unstructured":"Glaser N, Fritsch M, Priyambada L, Rewers A, Cherubini V, Estrada S, Wolfsdorf JI, Codner E. ISPAD clinical practice consensus guidelines 2022: Diabetic ketoacidosis and hyperglycemic hyperosmolar state. Pediatr Diabetes. 2022;23(7):835\u201386. https:\/\/doi.org\/10.1111\/pedi.13406.","journal-title":"Pediatr Diabetes"},{"issue":"10","key":"5334_CR4","doi-asserted-by":"publisher","first-page":"1633","DOI":"10.1016\/j.numecd.2020.06.006","volume":"30","author":"A Lapolla","year":"2020","unstructured":"Lapolla A, Amaro F, Bruttomesso D, Di Bartolo P, Grassi G, Maffeis C, Purrello F, Tumini S. Diabetic ketoacidosis: a consensus statement of the Italian Association of Medical Diabetologists (AMD), Italian society of Diabetology (SID), Italian Society of Endocrinology and Pediatric Diabetoloy (SIEDP). Nutr Metab Cardiovasc Dis. 2020;30(10):1633\u201344. https:\/\/doi.org\/10.1016\/j.numecd.2020.06.006.","journal-title":"Nutr Metab Cardiovasc Dis"},{"key":"5334_CR5","doi-asserted-by":"publisher","unstructured":"Rabbone I, Maltoni G, Tinti D, Zucchini S, Cherubini V, Bonfanti R, Scaramuzza A, Diabetes Study Group of the Italian Society for Pediatric Endocrinology and Diabetology (ISPED). Diabetic ketoacidosis at the onset of disease during a national awareness campaign: a 2-year observational study in children aged 0\u201318 years. Arch Dis Child. 2020;105(4):363-6. https:\/\/doi.org\/10.1136\/archdischild-2019-316903. Erratum in: Arch Dis Child. 2021;106(9):e39.","DOI":"10.1136\/archdischild-2019-316903"},{"issue":"5","key":"5334_CR6","doi-asserted-by":"publisher","first-page":"338","DOI":"10.1111\/pedi.12268","volume":"16","author":"DS Hsia","year":"2015","unstructured":"Hsia DS, Tarai SG, Alimi A, Coss-Bu JA, Haymond MW. Fluid management in pediatric patients with DKA and rates of suspected clinical cerebral edema. Pediatr Diabetes. 2015;16(5):338\u201344. https:\/\/doi.org\/10.1111\/pedi.12268.","journal-title":"Pediatr Diabetes"},{"issue":"1","key":"5334_CR7","doi-asserted-by":"publisher","first-page":"e001079","DOI":"10.1136\/bmjpo-2021-001079","volume":"5","author":"CE Rugg-Gunn","year":"2021","unstructured":"Rugg-Gunn CE, Deakin M, Hawcutt DB. Update and harmonisation of guidance for the management of diabetic ketoacidosis in children and young people in the UK. BMJ Paediatr Open. 2021;5(1):e001079. https:\/\/doi.org\/10.1136\/bmjpo-2021-001079.","journal-title":"BMJ Paediatr Open"},{"issue":"1","key":"5334_CR8","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1186\/s12909-019-1581-3","volume":"19","author":"M Binotti","year":"2019","unstructured":"Binotti M, Genoni G, Rizzollo S, De Luca M, Carenzo L, Monzani A, Ingrassia PL. Simulation-based medical training for paediatric residents in Italy: a nationwide survey. BMC Med Educ. 2019;19(1):161. https:\/\/doi.org\/10.1186\/s12909-019-1581-3.","journal-title":"BMC Med Educ"},{"issue":"12","key":"5334_CR9","doi-asserted-by":"publisher","first-page":"1251","DOI":"10.1007\/s12098-022-04159-3","volume":"89","author":"H Mendpara","year":"2022","unstructured":"Mendpara H, Bajpai A, Patel R, Shukla R, Kapoor R. The Development and Validation of a Mobile Application for Guidance for management of severe Diabetic Ketoacidosis. Indian J Pediatr. 2022;89(12):1251\u20136. https:\/\/doi.org\/10.1007\/s12098-022-04159-3.","journal-title":"Indian J Pediatr"},{"issue":"2","key":"5334_CR10","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1016\/S0377-1237(12)60040-9","volume":"68","author":"R Datta","year":"2012","unstructured":"Datta R, Upadhyay K, Jaideep C. Simulation and its role in medical education. Med J Armed Forces India. 2012;68(2):167\u201372. https:\/\/doi.org\/10.1016\/S0377-1237(12)60040-9.","journal-title":"Med J Armed Forces India"},{"key":"5334_CR11","doi-asserted-by":"publisher","first-page":"106","DOI":"10.3389\/fped.2015.00106","volume":"3","author":"R Ojha","year":"2015","unstructured":"Ojha R, Liu A, Rai D, Nanan R. Review of Simulation in Pediatrics: the evolution of a revolution. Front Pediatr. 2015;3:106. https:\/\/doi.org\/10.3389\/fped.2015.00106.","journal-title":"Front Pediatr"},{"key":"5334_CR12","doi-asserted-by":"publisher","first-page":"11098","DOI":"10.15766\/mep_2374-8265.11098","volume":"17","author":"C Roberts","year":"2021","unstructured":"Roberts C, Keilman A, Pearce J, Roberts A, Ching K, Kingsley J, Stephan A, Gross I, Ciener D, Augenstein J, Thomas A. Pediatric Emergency Medicine Didactics and Simulation (PEMDAS): Pediatric Diabetic Ketoacidosis. MedEdPORTAL. 2021;17:11098. https:\/\/doi.org\/10.15766\/mep_2374-8265.11098.","journal-title":"MedEdPORTAL"}],"container-title":["BMC Medical Education"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12909-024-05334-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12909-024-05334-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12909-024-05334-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,27]],"date-time":"2024-03-27T17:03:50Z","timestamp":1711559030000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcmededuc.biomedcentral.com\/articles\/10.1186\/s12909-024-05334-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,27]]},"references-count":12,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["5334"],"URL":"https:\/\/doi.org\/10.1186\/s12909-024-05334-0","relation":{},"ISSN":["1472-6920"],"issn-type":[{"value":"1472-6920","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,27]]},"assertion":[{"value":"17 October 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 March 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 March 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All subjects provided written informed consent to participate to the simulation study and to the tape-recording of scenarios. The need for ethics approval was deemed unnecessary by the local Ethics Committee (Comitato Etico Territoriale Interaziendale AOU Maggiore della Carit\u00e0 di Novara) because the study has negligible risks involving only health care professionals for education purposes and not involving patients.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"All subjects provided written informed consent for publication of collected data and recorded scenarios.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"345"}}