Evaluation of Neonatal Resuscitation Using High Fidelity Simulation and an Interprofessional Team

Abstract

Introduction: Neonatal resuscitation competency requires a combination of medical knowledge and teamwork behaviors. Traditional models of teaching neonatal resuscitation typically focus on skill acquisition within uniprofessional educational opportunities. Residents often feel unprepared to lead arrest teams despite having successfully completed resuscitation courses. Objective: Evaluate neonatal resuscitation performance of pediatric trainees during a simulated neonatal resuscitation scenario using an interprofessional team. Methods: In this study, 13 senior pediatric residents were asked to demonstrate neonatal resuscitation during a simulated neonatal megacode with 3 nurses and 1 respiratory therapist using a high-fidelity mannequin (Laerdal SimBaby). Performance was assessed on video review by two independent neonatologists using: two previously developed neonatal behavior checklists and the traditional AAP NRP megacode evaluation score sheet. Resident feedback was obtained through a standardized questionnaire. Results: All pediatric residents evaluated had previous NRP certification at the time of the study, but none within 18 months of the study date. Only 3 had previous high-fidelity experience. NRP scores and behavior scores for each resident and team did not vary significantly between raters. 6 of 13 residents did not receive a passing grade for the NRP megacode. A poor NRP megacode score did not correlate consistently with poor team or individual behavior scores. Teamwork behaviors (communication, information sharing, collaboration) could be identified even in residents with poor NRP scores. Residents rated the experience more highly than the allied health professionals (33.5+1.5 vs 30+1.0, p<0.001 (score out of 35)), although both valued the experience. Conclusions: This pilot study successfully demonstrates the ability to use the high-fidelity mannequin in teaching neonatal resuscitation. The use of an interprofessional team and a high-fidelity manikin may allow teamwork and leadership skills to be evaluated separately in a more realistic fashion.