We wanted to use simulation teaching to improve our multi-disciplinary team’s (MDT) management of children who presented to our Children and Young People’s ED (CYPED) with fever.
The aims of the study were: first, to use simulation teaching to train the MDT in our CYPED, to improve the care delivered to children presenting with fever, measured as an improvement in our compliance with the Royal College of Emergency Medicine’s (RCEM) standards 
. Secondly, to carry out the simulation teaching in a ‘pop-up’ style that can be delivered to staff within their clinical shifts on the shopfloor, without disturbing their work or the functioning of the CYPED.
For cycle one of our audits, we looked at a sample of 136 children who presented to our CYPED with fever; 61 patients met the inclusion criteria and were included. To improve compliance to the RCEM standards 
, we designed a 10-min, low-fidelity, simulation-based teaching session, requiring minimal resources. When staffing and acuity in the department allowed, we carried out ‘pop-up’ teaching in a spare CYPED cubicle. We ran four sessions, each lasting 1 to 3 h. Within these sessions, we ran the simulation 20 times, to 40 members of the MDT. To aid flexibility, we started each teaching session as and when staff attended. Following the teaching, staff self-rated their knowledge and ability to adhere to the RCEM standards on a 10-point Likert scale. To complete our PDSA cycle 
, we repeated the audit. We looked at a sample of 192 children, 87 met the inclusion criteria and were included.
Staff’s self-rated knowledge of the RCEM standards 
improved from 4.4 to 9.3 and their self-rated adherence to the standards improved from 5.4 to 9.3, on a 10-point Likert scale. This was reflected in improved compliance to the RCEM standards 1–6 
in the second audit cycle. The compliance with RCEM standards (1) from cycle 1 to cycle 2 was as follows: standard 1; 71% to 79%, standard 2; 59% to 78%, standard 3; 38% to 92%, standard 4; 74% to 66% and standard 5; 100% both cycles. Standard 6 is that the CYPED should provide training in sepsis recognition, which was achieved through our simulation sessions.
Implications for practice:
‘Pop-up’ style simulation teaching can be used to improve the care that we offer our patients, as reflected by an improvement in staff’s confidence and in the department’s compliance with RCEM standards 
. We endeavour to continue to use pop-up style simulation sessions within clinical shifts to continue to learn and strengthen as an MDT. In turn, we hope that this will improve the care that we offer our patients.