Multidisciplinary Neonatal Emergencies Simulation Team-Training (NEST) Improves Participant’s Confidence in Dealing With Simulated Neonatal Emergencies

Abstract

Background: A traditional medical curriculum has limited emphasis on communication skills, teamworking, and human factors. Simulation-based training emphasizes these skills and positively impacts patient safety. A group of Indian neonatologists in collaboration with their UK colleagues conducted adapted Neonatal Emergencies Simulation Team-training (NEST) courses in India. Aim: To evaluate the effectiveness of NEST courses in India and analyze the participant’s feedback Methods: A total of 16 NEST courses were conducted between November 2014 and February 2016. Structured pre- and postcourse feedback from participants was analyzed. Key domains studied included structured approach, human factors, situation-background-assessment-recommendation tool, and teamwork in an emergency. Each category was rated from 1 to 5, indicating a low to high scale. Pre- and posttraining scores and scores between centers were compared using the Wilcoxon signed-rank test and Kruskal-Wallis test, respectively. Results: A total of 191 feedbacks from 58 nurses and 133 doctors from 4 centers were analyzed. The comparison of self-reported pre- and postcourses showed a significant improvement across all domains. There was no statistical difference between scores from different centers showing consistent course results. Conclusions: We have demonstrated that the NEST multiprofessional course can be collaboratively delivered. The analysis of feedback shows a significant improvement in the candidate’s self-reported ability across all domains related to the application of the course principles to simulated neonatal emergencies.

The impact of a simulation-based approach to teaching crisis resource management for medical emergencies on neonatal intensive care units in the UK, India, Nepal and Saudi Arabia

“…The data presented by Swamy et al, 19 are similar to those described in previous studies which showed that high-fidelity simulation allows participants to practice their skills in communication, assessment, diagnosis, and treatment, as well as teamwork. 20,21 Knowledge is gained when candidates develop their own hypotheses and test these against their current understanding.…”

“…Course feedback was also consistent between centers. The evaluation by Swamy et al 19 demonstrates the efficacy of NEST courses in India. NEST India showcases the pioneering effort by neonatal pediatricians in a lowincome country.…”

“…There are limited data on the use of simulation training for neonatal emergencies in LMIC. Swamy teaching crisis resource management in neonatal intensive care units et al 19 systematically evaluated the impact of simulation-based training on NICU CRM on learners in India. They analyzed a total of 191 feedback forms (58 nurses; 133 doctors) from NEST India courses conducted at 4 centers in India.…”

“…It is therefore, not surprising that nurses' feedback on their NEST India experience highlighted their feeling of empowerment and integration into the team. 19 This was a significant achievement as working in teams and harnessing the valuable experience of these healthcare professionals is critically important for improving neonatal care. Similar themes were noted in the feedback comments from participants at all canters.…”