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Familiarity with the clinical environment, achieved by priming, improves time to antibiotic administration in a simulated paediatric sepsis scenario: a randomised control trial
  1. Ben McNaughten1,
  2. Lesley Storey2,
  3. Doris Corkin3,
  4. Pauline Cardwell3,
  5. Andrew Thompson4,
  6. Thomas Bourke4,5,
  7. Dara O'Donoghue4,5
  1. 1 Paediatrics, Antrim Area Hospital, Antrim, UK
  2. 2 Department of Psychology, School of Social Sciences, Birmingham City University, Birmingham, West Midlands, UK
  3. 3 School of Nursing, Queen's University Belfast, Faculty of Medicine Health and Life Sciences, Belfast, UK
  4. 4 Paediatics, Royal Belfast Hospital for Sick Children, Belfast, UK
  5. 5 Centre for Medical Education, Queens University Belfast, Belfast, UK
  1. Correspondence to Dr Ben McNaughten, Clinical Fellow, Royal Belfast Hospital for Sick Children, Belfast BT12 6BA, UK; bmcnaughten095{at}


Aim The early administration of antibiotics in sepsis reduces mortality and improves outcomes. This randomised control trial evaluated the effect of environmental priming (EP) on healthcare student performance in a simulated paediatric sepsis scenario.

Methods Medical and nursing students were randomised into primed and unprimed groups. Primed groups received both direct and virtual priming. Each group completed a standardised simulated sepsis scenario. Time to achieve five key clinical interventions was recorded. Mini focus groups were conducted to explore perceptions of EP.

Results There were 26 primed and 26 unprimed groups. The primed students were quicker to complete all five interventions and statistically significantly quicker to achieving intravenous (IV) access (median 350 s vs 373 s, p=0.02), administering IV antibiotics (median 648 s vs 760 s, p=0.045) and seeking senior help (median 703 s vs 780 s, p=0.02). Primed students did not feel that they had gained any specific advantage from being primed.

Conclusions EP can improve clinical performance. Implications for practice include incorporating EP of key clinical areas into local induction, standardisation of resuscitation areas and regular use of in situ simulation.

  • paediatric practice
  • medical education
  • general paediatrics

Data availability statement

Data are available upon reasonable request.

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Data availability statement

Data are available upon reasonable request.

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  • Contributors BMcN wrote the first draft of the manuscript. All coauthors were involved in reviewing and agreeing on the final manuscript for submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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