A delivery room-focused education and deliberate practice can improve pediatric resident resuscitation training

Barry, James; Gibbs, Margaret; Rosenberg, Adam A.

doi:10.1038/jp.2012.27

Cited by 22 publications

(16 citation statements)

References 38 publications

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“…[22][23][24][25][26][27]33 Before this study, research investigating the long-term effects of simulation training on pediatric residents' retention of knowledge and procedural skills yielded variable results. 18,20,21,23,24,27 The current study demonstrated that skill decay occurs despite the novel modality of HFS but found that retention varied based on the skills that were assessed. Group resuscitation performance deteriorated to a greater degree than cognitive knowledge, and both declined more than procedural proficiency.…”

Section: Discussionmentioning

confidence: 75%

“…[18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] High-fi delity simulation (HFS) uses computerized, interactive, lifesized pediatric manikins that offer realistic patient responses. HFS is gaining acceptance in medical training because of its safety, reproducibility, and ease of simulating critical events, and some studies have suggested that simulation is superior to traditional experiential training.…”

Section: Introductionmentioning

confidence: 99%

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High-Fidelity Simulation Enhances Pediatric Residents’ Retention, Knowledge, Procedural Proficiency, Group Resuscitation Performance, and Experience in Pediatric Resuscitation

Mills

Williams

et al. 2013

Hospital Pediatrics

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OBJECTIVE: The goal of this study was to assess the effect of high-fi delity simulation (HFS) pediatric resuscitation training on resident performance and self-reported experience compared with historical controls. METHODS:In this case-control study, pediatric residents at a tertiary academic children's hospital participated in a 16-hour HFS resuscitation curriculum. Primary outcome measures included cognitive knowledge, procedural profi ciency, retention, and self-reported comfort and procedural experience. The intervention group was compared with matched-pair historical controls. RESULTS:Forty-one residents participated in HFS training with 32 matched controls. The HFS group displayed signifi cant initial and overall improvement in knowledge (P < .01), procedural profi ciency (P < .05), and group resuscitation performance (P < .01). Signifi cant skill decay occurred in all performance measures (P < .01) with the exception of endotracheal intubation. Compared with controls, the HFS group reported not only greater comfort with most procedures but also performed more than twice the number of successful reallife pediatric intubations (median: 6 vs 3; P = .03). CONCLUSIONS:Despite signifi cant skill decay, HFS pediatric resuscitation training improved pediatric resident cognitive knowledge, procedural profi ciency, and comfort. Residents who completed the course were not only more profi cient than historical controls but also reported increased real-life resuscitation experiences and related procedures.

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Section: Discussionmentioning

confidence: 75%

Section: Introductionmentioning

confidence: 99%

High-Fidelity Simulation Enhances Pediatric Residents’ Retention, Knowledge, Procedural Proficiency, Group Resuscitation Performance, and Experience in Pediatric Resuscitation

Mills

Williams

et al. 2013

Hospital Pediatrics

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“…7,12,13,29 Like others, we observed an inability to draw epinephrine from a vial, as well as an inability to place and correctly secure an endotracheal tube or a UVC, even after the completion of traditional NRP. 3,4,7,20,24,30 Most investigators have focused on the technical aspects of procedural skills and not on the timeliness of the task. 31,32 Our assessment also included an evaluation of the timeliness (time to initiation or time to completion) of each individual skill.…”

Section: Discussionmentioning

confidence: 99%

“…In light of the above, it is possible that a more structured, delivery room-centered, short intervention that includes simulation and deliberate practice may be necessary to improve performance. 30,33 Team behaviors can be assessed during real-life DR resuscitations or in simulated scenarios similar to ours. 2,21,34 Video recordings facilitate evaluation of behaviors and global team performances.…”

Section: Discussionmentioning

confidence: 99%

Pediatrics Residents' Preparedness for Neonatal Resuscitation Assessed Using High-Fidelity Simulation

Cordero¹,

Hart²,

Hardin³

et al. 2013

Journal of Graduate Medical Education

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Background Pediatrics residents are expected to demonstrate preparedness for neonatal resuscitation, yet research has shown gaps in residents' readiness to perform this skill. Objective To evaluate procedural skills and team performance of pediatrics residents during neonatal resuscitation (NR) using a high-fidelity mannequin, and to assess residents' confidence in their NR skills before and after training. Methods Two teams of residents (all had completed NR program training) participated in 2 separate, 90-minute sessions (2 to 3 weeks apart) in an off-site delivery room during their neonatal intensive care rotation. Residents' confidence in assisting and leading NR was surveyed before each session. Teams participated in a scenario (adapted from the NR program), which required 5 skills (positive pressure ventilation, chest compressions, endotracheal intubation, umbilical vein catheterization, and epinephrine administration). Video recording was used for debriefing and scoring. Skills were scored for technique and timeliness, and team behaviors were scored for communication, management, and leadership. Results Twenty-six residents (11 teams) completed 2 paired sessions. Self-confidence scores increased between the 2 sessions but were not correlated with performance. Gaps in procedural skill performance were observed, and timeliness for most skills did not meet expectations. Significant improvement in team communication was noted. Conclusions Important gaps in procedural skill performance, particularly timeliness, were detected by NR simulation training; residents' improvements in self-confidence did not reflect gains in actual performance. Their relative unpreparedness for NR (despite prior certification) highlights the need for deliberate practice and specific team training before and during neonatal intensive care delivery room rotations.

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“…61,62 DP consists of structured sessions wherein learners work toward achieving specific defined goals through repetitive practice with feedback. This method has been found to be superior to traditional instruction for teaching neonatal resuscitation preparation 63 and performance, 64 as well as pediatric resuscitation skills. 65 It should be emphasized that DP programs do not have to be time-intensive.…”

Section: Frequency Of Instructionmentioning

confidence: 99%

Pediatric Resuscitation Education in Low-Middle-Income Countries: Effective Strategies for Successful Program Development

Jung

Shilkofski

2016

J Pediatr Intensive Care

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Despite established international guidelines, there is considerable variability in the quality of resuscitative care received by critically ill children in low-middle-income countries. While this problem is certainly multifactorial, education of health care workers is an important determinant of care quality. This article will discuss approaches to health care worker education in pediatric resuscitation in low-middle-income countries, with emphasis on aspects of educational programs that may contribute to positive educational and clinical outcomes.

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A delivery room-focused education and deliberate practice can improve pediatric resident resuscitation training

Abstract: Objective: To determine if deliberate practice and simulation would improve pediatric residents' neonatal resuscitation abilities.

Cited by 22 publications

References 38 publications

High-Fidelity Simulation Enhances Pediatric Residents’ Retention, Knowledge, Procedural Proficiency, Group Resuscitation Performance, and Experience in Pediatric Resuscitation

High-Fidelity Simulation Enhances Pediatric Residents’ Retention, Knowledge, Procedural Proficiency, Group Resuscitation Performance, and Experience in Pediatric Resuscitation

Pediatrics Residents' Preparedness for Neonatal Resuscitation Assessed Using High-Fidelity Simulation

Pediatric Resuscitation Education in Low-Middle-Income Countries: Effective Strategies for Successful Program Development

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