1542 Feasibilty of using High Fidelity Simulation Exercises to Evaluate and Enhance Neonatal Resuscitation Skills

Abstract

Background and Aims Pediatric house officers (HO) use neonatal resuscitation (NR) skills during their rotations in the neonatal intensive care unit (NICU). To improve HOs' competence and retention of skills in NR we implemented NR practice sessions using high fidelity simulation (HFS) twice for each HO during their NICU rotation. This study explored the feasibility of using HFS to assess key NR skills, both at baseline and following exposure to assess improvement. Methods We administered two standardized NR HFS sessions for each HO (n=46) during their NICU rotation in 2010. HOs served as team leaders in during the NR scenario. We assessed total time to complete the scenario, total time to successful intubation, and the frequency of markers of NR and teamwork skills during the first and second HFS sessions. Results We detected multiple failures in key NR and team work skills at the initial HFS sessions, such as ineffective positive pressure ventilation (PPV) (28%), more than one attempt of intubation (30%), incorrect decision to start chest compressions (CC) (30%), and failure to coordinate CC and PPV (52%), not asking for help (59%), roles not defined (22%). Assessment of teamwork showed a trend for improvement between the first and second sessions. However, differences of markers of NR performance were not statistically significant. Conclusions We detected frequent deficiencies in NR skills and no significant improvement after exposure to a single HFS NR session. In order to achieve sustained improvement in NR skills, further practice and skills-based curricula may be necessary.