In Situ Simulation Training for Neonatal Resuscitation: An RCT

Abstract

WHAT'S KNOWN ON THIS SUBJECT: High-fidelity simulation improves individual skills in neonatal resuscitation. Usually, training is performed in a simulation center. Little is known about the impact of in situ training on overall team performance. WHAT THIS STUDY ADDS:In situ high-fidelity simulation training of 80% of a maternity' s staff significantly improved overall team performance in neonatal resuscitation (technical skills and teamwork). Fewer hazardous events occurred, and delay in improving the heart rate was shorter. abstract OBJECTIVES: High-fidelity simulation is an effective tool in teaching neonatal resuscitation skills to professionals. We aimed to determine whether in situ simulation training (for ∼80% of the delivery room staff) improved neonatal resuscitation performed by the staff at maternities. METHODS:A baseline evaluation of 12 maternities was performed: a random sample of 10 professionals in each unit was presented with 2 standardized scenarios played on a neonatal high-fidelity simulator. The medical procedures were video recorded for later assessments. The 12 maternities were then randomly assigned to receive the intervention (a 4-hour simulation training session delivered in situ for multidisciplinary groups of 6 professionals) or not receive it. All maternities were evaluated again at 3 months after the intervention. The videos were assessed by 2 neonatologists blinded to the pre-/postintervention as well as to the intervention/control groups. The performance was assessed using a technical score and a team score. RESULTS:After intervention, the median technical score was significantly higher for scenarios 1 and 2 for the intervention group compared with the control group (P = .01 and 0.004, respectively), the median team score was significantly higher (P , .001) for both scenarios. In the intervention group, the frequency of achieving a heart rate .90 per minute at 3 minutes improved significantly (P = .003), and the number of hazardous events decreased significantly (P , .001). CONCLUSIONS:In situ simulation training with multidisciplinary teams can effectively improve technical skills and teamwork in neonatal resuscitation. Pediatrics 2014;134:e790-e797

Newborn Resuscitation Training Programmes Reduce Early Neonatal Mortality

“…The quality of evidence was rated very low because of unit of analysis error and evidence available from only 2 studies. In randomised studies, Lee et al [30] and Rubio-Gurung et al [31 ]reported on resuscitation scores and team scores. We are awaiting more data to be considered for inclusion in the meta-analyses.…”

Effect of a Low-Dose/High-Frequency Training on Real-Life Neonatal Resuscitation in a Low-Resource Setting

“…In situ simulation and lowdose/high-frequency training have been demonstrated to be effective in high-resource settings [13], and encouraging results have been reported in low-resource settings [14][15][16][17]. Our previous study in a low-resource setting showed improved clinical performance of midwives after participation in an adapted NRP course, while the quality and timing of resuscitations remained below the recommended standards [18].…”

Use of Simulation in Canadian Neonatal-Perinatal Medicine Training Programs

“…It is effective in improving knowledge and in many fields has been clearly associated with improved performance [9][10]. Simulation is being used for interprofessional training [11], and specialized simulation-based fellowship programs are expanding across North America [12]. With the shift towards competency-based curriculums, simulation is becoming increasingly important as a training and evaluation tool.…”