Table 4. Top Three Challenges Encountered During the In-Situ Simulation Training by Specialty.

	Pediatric emergency	Adult emergency	Anesthesia
Airway management	Anticipation of difficult airway	Preparation of intubation equipment	Anticipation of difficult airway
	Assignment of the most expert provider to perform intubation	Using non-rebreathing mask/using high flow nasal cannula/avoidance non-invasive ventilation	Closure of the suction system
	Use of video laryngoscopy	Anticipation of difficult airway	Administration of low flow O2 in case desaturation with minimal pressure < 20 mm Hg
Infection control	Minimization of the total number of personnel inside the room	Adherence to the proper sequence of doffing	Preparation of all needed equipment outside the intubation room
	Prioritization of healthcare workers safety	Avoidance of incomplete donning or doffing of the PPE	Attachment of a viral filter
	Adherence to the proper sequence of donning	Consideration of using plastic cover for the pediatric or plastic box for adult	Following CDC/institutional guidelines in aerosol-generating procedure
Team dynamic	Speaking up	Assure closed-loop communication	Speaking up
	Assignment of the team and clarity of roles	Speaking up	Assignment of the team and clarity of roles
	Loudness and clarity of the team leader voice	Synchronous communication between the team leader and team	Loudness and clarity of the team leader voice

CDC: Centers for Disease Control and Prevention; PPE: personal protective equipment.