Neonatal resuscitation: advances in training and practice

Sawyer, Taylor; Umoren, Rachel; Gray, Megan

doi:10.2147/amep.s109099

Cited by 54 publications

(49 citation statements)

References 17 publications

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“…During the course they participate in skills stations, integrated skills stations and then have a team based simulation with debriefing afterwards. The debrief remains the critical element of this learning process (8,9).…”

Section: Why Simulation?mentioning

confidence: 99%

Simulation in Neonatal Resuscitation

Garvey

Dempsey

2020

Front. Pediatr.

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Approximately 1 in 10 newborns will require basic resuscitation interventions at birth. Some infants progress to require more advanced measures including the provision of positive pressure ventilation, chest compressions, intubation and administration of volume/cardiac medications. Although advanced resuscitation is infrequent, it is crucial that personnel adequately trained in these techniques are available to provide such resuscitative measures. In 2000, Louis Halmalek et al. called for a "New Paradigm in Pediatric Medical Education: Teaching Neonatal Resuscitation in a Simulated Delivery Room Environment." This was one of the first articles to highlight simulation as a method of teaching newborn resuscitation. The last decades have seen an exponential growth in the area of simulation in newborn care, in particular in newborn resuscitation and stabilization. Simulation is best defined as an instructional strategy "used to replace or amplify real experiences with guided experiences that evoke or replicate substantial aspects of the real world in a fully interactive manner." Simulation training has now become an important point of how we structure training and deliver improved healthcare to patients. Some of the key aspects of simulation training include feedback, deliberate practice, outcome measurement, retention of skills and curriculum integration. The term "Train to win" is often used in sporting parlance to define how great teams succeed. The major difference between sports teams is that generally their game day comes once a week, whereas in newborn resuscitation every day is potentially "game day." In this review we aim to summarize the current evidence on the use of simulation based education and training in neonatal resuscitation, with particular emphasis on the evidence supporting its effectiveness. We will also highlight recent advances in the development of simulation based medical education in the context of newborn resuscitation to ensure we "train to win."

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Section: Why Simulation?mentioning

confidence: 99%

Simulation in Neonatal Resuscitation

Garvey

Dempsey

2020

Front. Pediatr.

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“…A broad grass-roots approach that engages stakeholders in training institutions, state and national ministries of health, ministries of education, industry and health professional organisations is needed to support the integration of SBT into pre-service training and continuing education programme for in-service healthcare workers. Continuing education programme support the acquisition and retention of skills after initial training and have been important sources of sustainable funding for SBT in high-income settings 7 13–16. These mechanisms may be leveraged to support SBT in resource-scarce settings.…”

Section: Discussionmentioning

confidence: 99%

“…Simulation-based training (SBT) is supported by adult learning theories such as the Kolb’s experiential learning theory3 4 and the Ericsson’s deliberate practice theory5 and is near the top of the Kirkpatrick triangle for supporting increased retention of knowledge and skills 6. For this reason, elements of SBT have been integrated into many global maternal and newborn health programme such as the Neonatal Resuscitation Program (NRP) and Helping Babies Survive 7 8…”

Section: Introductionmentioning

confidence: 99%

“…The majority of paediatric SBT in high-income countries is associated with standardised resuscitation training programme such as NRP and paediatric advanced life support 7. This training is conducted in two parts using online simulation (NRP eSIM and HeartCode) and manikin-based simulation in clinical simulation facilities that are set up to mimic actual clinical settings with fixtures such as suction and gas outlets and equipment including cardiac monitors, infant warmers and hospital beds 7. In situ simulations occur in healthcare facilities and are designed to provide convenient opportunities for practice in the healthcare setting and to identify patient safety risks 9 10…”

Section: Introductionmentioning

confidence: 99%

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Perspectives on simulation-based training from paediatric healthcare providers in Nigeria: a national survey

et al. 2020

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ObjectivesThe objective of this study was to explore the access to, and perceived utility of, various simulation modalities by in-service healthcare providers in a resource-scarce setting.SettingPaediatric training workshops at a national paediatric conference in Nigeria.ParticipantsAll 200 healthcare workers who attended the workshop sessions were eligible to participate. A total of 161 surveys were completed (response rate 81%).Primary and secondary outcome measuresA paper-based 25-item cross-sectional survey on simulation-based training (SBT) was administered to a convenience sample of healthcare workers from secondary and tertiary healthcare facilities.ResultsRespondents were mostly 31–40 years of age (79, 49%) and women (127, 79%). Consultant physicians (26, 16%) and nurses (56, 35%) were in both general (98, 61%) and subspecialty (56, 35%) practice. Most had 5–10 years of experience (62, 37%) in a tertiary care setting (72, 43%). Exposure to SBT varied by profession with physicians more likely to be exposed to manikin-based (29, 30% physicians vs 12, 19% nurses, p<0.001) or online training (7, 7% physician vs 3, 5% nurses, p<0.05). Despite perceived barriers to SBT, respondents thought that SBT should be expanded for continuing education (84, 88% physician vs 39, 63% nurses, p<0.001), teaching (73, 76% physicians vs 16, 26% nurses, p<0.001) and research (65, 68% physicians vs 14, 23% nurses, p<0.001). If facilities were available, nearly all respondents (92, 98% physicians; 52, 96% nurses) would recommend the use of online simulation for their centre.ConclusionsThe access of healthcare workers to SBT is limited in resource-scarce settings. While acknowledging the challenges, respondents identified many areas in which SBT may be useful, including skills acquisition, skills practice and communication training. Healthcare workers were open to the use of online SBT and expressed the need to expand SBT beyond the current scope for health professional training in Nigeria.

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“…In recent decades, there has been a steady increase in the use of simulation-based education (SBE) for training healthcare providers in technical and non-technical skills. 1 However, much of the focus of simulation education and research programs has been on clinical knowledge, technical skills, and patient outcomes, [2][3][4] rather than on economic impact, value, or cost-benefit relationships. Currently, in both high-and low-income countries, institutional training programs, including simulation laboratories, are being scrutinized more carefully for return on investment or costs versus benefits.…”

Section: Introductionmentioning

confidence: 99%

A targeted systematic review of cost analyses for implementation of simulation-based education in healthcare

et al. 2020

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Over the past two decades, there has been an increase in the use of simulation-based education for training healthcare providers in technical and non-technical skills. Simulation education and research programs have mostly focused on the impact on clinical knowledge and improvement of technical skills rather than on cost. To study and characterize existing evidence to inform multi-stakeholder investment decisions, we performed a systematic review of the literature on costs in simulation-based education in medicine in general and in neonatal resuscitation as a particular focus. We conducted a systematic literature search of the PubMed database using two targeted queries. The first searched for cost analyses of healthcare simulation-based education more broadly, and the second was more narrowly focused on cost analyses of neonatal resuscitation training. The more general query identified 47 qualified articles. The most common specialties for education interventions were surgery (51%); obstetrics, gynecology, or pediatrics (11%); medicine, nursing, or medical school (11%); and urology (9%), accounting for over 80% of articles. The neonatal resuscitation query identified five qualified articles. The two queries identified seven large-scale training implementation studies, one in the United States and six in low-income countries. There were two articles each from Tanzania and India and one article each from Zambia and Ghana. Methods, definitions, and reported estimates varied across articles, implying interpretation, comparison, and generalization of program effects are challenging. More work is needed to understand the costs, processes, and outcomes likely to make simulation-based education programs cost-effective and scalable. To optimize return on investments in training, assessing resource requirements, associated costs, and subsequent outcomes can inform stakeholders about the potential sustainability of SBE programs. Healthcare stakeholders and decision makers will benefit from more transparent, consistent, rigorous, and explicit assessments of simulation-based education program development and implementation costs in low- and high-income countries.

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Neonatal resuscitation: advances in training and practice

Cited by 54 publications

References 17 publications

Simulation in Neonatal Resuscitation

Simulation in Neonatal Resuscitation

Perspectives on simulation-based training from paediatric healthcare providers in Nigeria: a national survey

A targeted systematic review of cost analyses for implementation of simulation-based education in healthcare

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