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Haynes JC, Rettedal SI, Ushakova A, Perlman JM, Ersdal HL. How Much Training Is Enough? Low-Dose, High-Frequency Simulation Training and Maintenance of Competence in Neonatal Resuscitation. Simul Healthc 2024:01266021-990000000-00112. [PMID: 38445834 DOI: 10.1097/sih.0000000000000783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
INTRODUCTION Facemask ventilation is a crucial, but challenging, element of neonatal resuscitation.In a previously reported study, instructor-led training using a novel neonatal simulator resulted in high-level ventilation competence for health care providers (HCPs) involved in newborn resuscitation. The aim of this study was to identify the optimal frequency and dose of simulation training to maintain this competence level. METHODS Prospective observational study of HCPs training through 9 months. All training was logged. Overall ventilation competence scores were calculated for each simulation case, incorporating 7 skill elements considered important for effective ventilation.Overall scores and skill elements were analyzed by generalized linear mixed effects models using frequency (number of months of 9 where training occurred and total number of training sessions in 9 months) and dose (total number of cases performed) as predictors. Training loads (frequency + dose) predictive of high scores were projected based on estimated marginal probabilities of successful outcomes. RESULTS A total of 156 HCPs performed 4348 training cases. Performing 5 or more sessions in 9 months predicted high global competence scores (>28/30). Frequency was the best predictor for 4 skill elements; success in maintaining airway patency and ventilation fraction was predicted by performing training in, respectively, 2 and 3 months of 9, whereas for avoiding dangerously high inflating pressures and providing adequate mask seal, 5 and 6 sessions, respectively, over the 9 months, predicted success. Skills reflecting global performance (successful resuscitation and valid ventilations) and ventilation rate were more dose-dependent. CONCLUSIONS Training frequency is important in maintaining neonatal ventilation competence. Training dose is important for some skill elements. This offers the potential for individualized training schedules.
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Affiliation(s)
- Joanna C Haynes
- From the Department of Anaesthesia (J.C.H., H.L.E.), Stavanger University Hospital, Stavanger, Norway; Faculty of Health Sciences (J.C.H., S.I.R., H.L.E.), University of Stavanger, Stavanger, Norway; Department of Paediatrics (S.I.R.), Stavanger University Hospital, Stavanger, Norway; Department of Biostatistics (A.U.), Stavanger University Hospital, Stavanger, Norway; and Department of Pediatrics (J.M.P.), Weill Cornell Medicine, New York, NY
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Kim E, Song S, Kim S. Development of pediatric simulation-based education - a systematic review. BMC Nurs 2023; 22:291. [PMID: 37641090 PMCID: PMC10463597 DOI: 10.1186/s12912-023-01458-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 08/22/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND This systematic literature review explored the general characteristics, validation, and reliability of pediatric simulation-based education (P-SBE). METHODS A literature search was conducted between May 23 and 28 using the PRISMA guidelines, which covered databases such as MEDLINE, EMBASE, CINAHL, and Cochrane Library. In the third selection process, the original texts of 142 studies were selected, and 98 documents were included in the final content analysis. RESULTS A total of 109 papers have been published in the ten years since 2011. Most of the study designs were experimental studies, including RCT with 76 articles. Among the typologies of simulation, advanced patient simulation was the most common (92), and high-fidelity simulation was the second most common (75). There were 29 compatibility levels and professional levels, with 59 scenarios related to emergency interventions and 19 scenarios related to communication feasibility and decision making. Regarding the effect variable, 65 studies confirmed that skills were the most common. However, validity of the scenarios and effect variables was not verified in 56.1% and 67.3% of studies, respectively. CONCLUSION Based on these findings, simulation based-education (SBE) is an effective educational method that can improve the proficiency and competence of medical professionals dealing with child. Learning through simulation provides an immersive environment in which learners interact with the presented patient scenario and make decisions, actively learning the attitudes, knowledge, and skills necessary for medical providers. In the future, it is expected that such research on SBE will be actively followed up and verified for its validity and reliability.
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Affiliation(s)
- EunJoo Kim
- Department of Nursing, Gangneung-Wonju National University, 150, Namwon-ro, Heungop- myeon, Wonju-si, 26403, Gangwon-do, Republic of Korea
| | - SungSook Song
- Department of Nursing, INHA University, 313, Docbae-ro, Michuhol-gu, Incheon, 22188, Republic of Korea
| | - SeongKwang Kim
- Department of Nursing, Gangneung-Wonju National University, 150, Namwon-ro, Heungop- myeon, Wonju-si, 26403, Gangwon-do, Republic of Korea.
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Choi S, Shim H, Lee JH. Efficiency analysis by training sequence of high-fidelity simulation-based neonatal resuscitation program (NRP). PLoS One 2023; 18:e0281515. [PMID: 36763618 PMCID: PMC9916567 DOI: 10.1371/journal.pone.0281515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 01/25/2023] [Indexed: 02/11/2023] Open
Abstract
OBJECTIVE This study was conducted to find a more effective education method in a neonatal resuscitation program (NRP) using a high-fidelity simulation that has recently shown positive results in terms of its effectiveness. STUDY DESIGN A single-blind prospective cohort study was performed. The high-fidelity simulation model was used in a formal NRP training course for trainees caring for neonatal patients. The trainees were divided into a group that conducted the scenario after the lecture (Group A) and a group that attended the lecture after the scenario (Group B) and they both took the test before, during, and after the training. RESULTS The increase in score after theory training was statistically significant in both groups, but the final score did not differ between the two groups. However, when compared by career, in Group A, trainees under 24 months tended to be more effective, and in Group B, trainees over 24 months tended to be more effective. CONCLUSION The difference in short-term memory of trainees according to the order of education identified by the test score was not prominent, but it was found that the degree of difference in test scores for the order of education tended to be different according to the career. It is thought that the effectiveness of the training might be increased by changing the education order according to the degree of experience of each trainee. More effective educational methods should be introduced by continuously developing lectures for repeated education of various trainees in the future.
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Affiliation(s)
- Seoheui Choi
- Department of Paediatrics, Ajou University School of Medicine, Suwon, South Korea
| | - Hoyeon Shim
- Department of Simulation Center, Hallym University Dongtan Sacred Heart Hospital, Hwaseong-si, South Korea
| | - Jang H. Lee
- Department of Paediatrics, Ajou University School of Medicine, Suwon, South Korea
- * E-mail:
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Carbajal MM, Dadiz R, Sawyer T, Kane S, Frost M, Angert R. Part 5: Essentials of Neonatal-Perinatal Medicine Fellowship: evaluation of competence and proficiency using Milestones. J Perinatol 2022; 42:809-814. [PMID: 35149835 DOI: 10.1038/s41372-021-01306-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 11/03/2021] [Accepted: 12/23/2021] [Indexed: 11/09/2022]
Abstract
The Accreditation Council for Graduate Medical Education (ACGME) Pediatric Subspecialty Milestone Project competencies are used for Neonatal-Perinatal Medicine (NPM) fellows. Milestones are longitudinal markers that range from novice to expert (levels 1-5). There is no standard approach to the required biannual evaluation of fellows by fellowship programs, resulting in significant variability among programs regarding procedural experience and exposure to pathology during clinical training. In this paper, we discuss the opportunities that Milestones provide, potential strategies to address challenges, and future directions.
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Affiliation(s)
- Melissa M Carbajal
- Department of Pediatrics, Section of Neonatology, Baylor College of Medicine, Houston, TX, USA.
| | - Rita Dadiz
- Departments of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Taylor Sawyer
- Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA
| | - Sara Kane
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Mackenzie Frost
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | | | - Robert Angert
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA
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Use of a Novel Manikin for Neonatal Resuscitation Ventilation Training. CHILDREN 2022; 9:children9030364. [PMID: 35327735 PMCID: PMC8947467 DOI: 10.3390/children9030364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 02/23/2022] [Accepted: 03/01/2022] [Indexed: 11/17/2022]
Abstract
All providers who attend deliveries independently should be well versed in the performance of effective ventilation, assessment of the quality of ventilation/interventions supplied and able to troubleshoot in situations where these may be ineffective. A novel manikin serves as a unique ventilation-focused training tool to practice these clinical skills and decision-making. The data generated by the manikin, with the aid of a facilitator, may be used for formative and summative feedback on an individual level or curricular development on a larger level. This communication describes the importance of focused ventilation training for front-line providers and illustrates how this manikin can be incorporated into an individualized ventilation training program.
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Pescador Chamorro MI, Zeballos Sarrato SE, Marsinyach Ros MI, Zeballos Sarrato G, Márquez Isidro EM, Sánchez Luna M. Training, experience and need of booster courses in neonatal cardiopulmonary resuscitation. Survey to pediatricians. ANALES DE PEDIATRÍA (ENGLISH EDITION) 2022; 96:122-129. [DOI: 10.1016/j.anpede.2020.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 11/13/2020] [Indexed: 11/25/2022] Open
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Pescador Chamorro MI, Zeballos Sarrato SE, Marsinyach Ros MI, Zeballos Sarrato G, Márquez Isidro EM, Sánchez Luna M. [Training, experience and need of booster courses in neonatal cardiopulmonary resuscitation. Survey to pediatricians]. An Pediatr (Barc) 2020; 96:S1695-4033(20)30497-5. [PMID: 33390358 DOI: 10.1016/j.anpedi.2020.11.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 11/10/2020] [Accepted: 11/13/2020] [Indexed: 01/13/2023] Open
Abstract
INTRODUCTION the resuscitation of the newborn in the delivery room requires high capacities and occurs frequently in an unexpected way. Many professionals trained in pediatrics as pediatric residents will work posteriorly in pediatric units with delivery rooms and will perform neonatal resuscitation only occasionally. Skills acquired in practice or resuscitation courses deteriorate over time. MATERIAL AND METHODS descriptive observational study through a survey to pediatricians trained in neonatology at a tertiary hospital in Madrid, and who completed their residency period between 2009 and 2016. Questions about their training in resuscitation and their usual work in the delivery room. RESULTS Out of 179 surveys sent 140 pediatricians (78,2%) answered it. 73.6% took a training course in neonatal resuscitation during the residency. There was a progressive increase in the number of residents who did the course during the study period. 74.3% have worked after residency in assistance at birth. 40.7% have taken a refresher course in neonatal resuscitation. CONCLUSIONS training in neonatal resuscitation has increased and been consolidated during the training process for pediatric residents. A high percentage of pediatricians work after the residency in pediatric units with delivery rooms, less than half of these professionals having been recycled in neonatal resuscitation. Recycling and periodic training seem interesting options to improve the performance of these professionals in the delivery room.
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Affiliation(s)
| | | | | | | | | | - Manuel Sánchez Luna
- Servicio de Neonatología, Hospital General Universitario Gregorio Marañón, Madrid, España
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Sawyer T. Educational Perspectives: Educational Strategies to Improve Outcomes from Neonatal Resuscitation. Neoreviews 2020; 21:e431-e441. [PMID: 32611561 DOI: 10.1542/neo.21-7-e431] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Since 1987, the Neonatal Resuscitation Program (NRP) course has taught the cognitive, technical, and behavioral skills required to effectively resuscitate newborns. To remain relevant and effective, the NRP course needs to continually evolve and embrace evidence-based educational strategies proven to improve outcomes from resuscitation. In this Educational Perspectives article, 6 educational strategies that can be applied to neonatal resuscitation education are reviewed. These educational strategies include mastery learning and deliberate practice, spaced practice, contextual learning, feedback and debriefing, assessment, and innovative educational strategies Then knowledge translation and implementation of these educational strategies through passive and active knowledge translation, change theory, design thinking, performance measurement, deadoption strategies, continuous quality improvement, incentive and penalties, and psychological marketing are explored. Finally, ways to optimize faculty development of NRP instructors, including both initial instructor training and ongoing instructor development, are examined. The goal of this review is to help NRP program developers and instructors use evidence-based educational strategies to improve neonatal resuscitation outcomes.
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Affiliation(s)
- Taylor Sawyer
- Department of Pediatrics, Division of Neonatology, University of Washington School of Medicine and Seattle Children's Hospital, Seattle, WA
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