Effectiveness of Integrating High-fidelity Simulation and Team-Based Learning in Pediatric postgraduates CPR Training: A Mixed Method Running Head：High-fidelity Simulation and TBL

Abstract Background Given the overall lack of cardiopulmonary resuscitation (CPR) training in society, Standardized CPR training is very imperative to bolster widespread CPR adoption. At present, the traditional teaching method is not conducive to improving students' comprehensive ability, however, there is limited literature on the combined use of high-fidelity simulation and team-based learning (TBL) in pediatric graduate student education. The study aimed to evaluate the effectiveness of using high-fidelity simulation combined with TBL teaching method in standardized training of cardiopulmonary resuscitation for pediatric postgraduates. Methods This mixed-methods study involved twenty-four postgraduate students as experimental subjects. The teaching intervention comprised high-fidelity simulation combined with the team-based learning (TBL) method. Notably, all participants were new to this combined approach, having previously been exposed to traditional teaching methods. We measured total learning performance with a pre-post design. Subsequently, semi-structured interviews were employed, and data analysis followed Colaizzi's methodology. NVivo 12.0 was used to code and analyze interview records. Results The high-fidelity simulation + TBL teaching method led to significant improvements in clinical operation scores, including hands-on CPR (80.95 ± 5.81 vs 88.46 ± 7.35), endotracheal intubation (76.03 ± 6.51 vs 81.89 ± 9.72), defibrillation (79.96 ± 4.37 vs 89.84 ± 3.98), and team collaboration (28.33 ± 2.46 vs 32.99 ± 2.85) (P < 0.05). Additionally, a comprehensive qualitative analysis identified 10 core themes, which could be grouped into four thematic clusters: "Reflection and feedback," "Highly simulated clinical scenario," "Improving clinical thinking," and "Teamwork and communication." Conclusion The integration of high-fidelity simulation and TBL enhances teaching efficiency and overall clinical emergency response capabilities for postgraduate students, offering structured small group learning applicable to standardized pediatric CPR training.