Enhancing Pediatric Residency Training Through Peer-Education Based Gamified Simulation.

The reduction in clinical rotation hours, particularly in high-demand pediatric subspecialties such as Neonatal Intensive Care Units (NICU) and Pediatric Emergency Rooms (ER), has highlighted the need for innovative approaches to enhance pediatric residency education. A 2019 survey of Italian pediatric residency programs revealed that most residents receive fewer than five hours of simulation-based training annually, with 66% participating in no simulation activities. Additionally, pediatric ER rotation hours have seen significant reductions-daytime rotations decreased by 29%, while nighttime rotations were reduced by 60% over the past four years at the University of Genoa. These challenges emphasize the importance of simulation-based curricula to address gaps in clinical exposure.This study presents a gamified simulation-based curriculum developed at the University of Genoa, designed to improve both technical and non-technical competencies among pediatric residents while compensating for reduced clinical exposure. The curriculum spans five years, with Year 1 focusing on foundational skills such as airway management, vascular access, and diagnostic techniques. Year 2 introduces more advanced scenarios like neonatal resuscitation, shock management, and cardiac arrest, while Years 3-5 culminate in high-fidelity simulations involving complex trauma and crisis resource management.Throughout the program, gamification elements such as badges, leaderboards, and team-based rewards enhance engagement, motivation, and participation. These elements provide feedback and foster progression, reinforcing residents' commitment to mastering technical skills and non-technical competencies like teamwork, leadership, and decision-making. By combining simulation-based training with gamification, this curriculum offers an innovative approach to residency education, preparing pediatric residents for real-world challenges and developing essential skills for high-stakes pediatric care.