OJPed  Vol.2 No.4 , December 2012
Evaluation of participants' feedback after a simulation-based training in neonatal resuscitation using a realistic delivery room
Abstract: BACKGROUND: Low-frequency and high-risk situations, such as neonatal resuscitation, are the ideal targets for simulation-based learning. The aim of this paper is to present the structure of our internal neonatal resuscitation training program, using a realistic, simulated delivery room, and to present the participants' opinions about teamwork, emotional stress, and their subjective ability to face a resuscitation. METHODS: We administered a training course to 24 doctors and midwives. One of the simulation classrooms was modified to appear similar to a real delivery room. Four scenarios were conducted using a previously designed checklist of primary and secondary goals. Upon completion, all students participated in a debriefing session with the help of a video review. RESULTS: Students rated the achievement of their previously defined goals on a scale of 1 to 5. Grouping together the percentages of the highest ratings (Categories 4 and 5), 83.4% (20/24) of the students considered the course useful for acquiring clinical skills. For 87.5% (21/24) of the students, the scenarios simulated real clinical situations, the room properly simulated a real delivery room, and the course improved the students' ability to work in a team. For 66.6% (16/24) of the students, the course improved their stress in confronting neonatal resuscitation. Initially, only 33.3% (8/24) of the students considered themselves very capable or fully able to cope with a resuscitation. After the course, that percentage rose to 62.5% (15/24). CONCLUSIONS: The incorporation of simulation-based learning into neonatal resuscitation teaching programs, using realistic scenarios, is useful and offers the possibility of acquiring technical skills, but it also allows for the improvement of teamwork and the adoption of different roles and positive attitudes towards emotional stress.
Cite this paper: Avila-Alvarez, A. , Gonzalez-Rivera, I. , L. Fernandez-Trisac, J. , I. Taboada-Perianes, M. , Rodriguez-Gonzalez, B. , Centeno-Cortes, A. , Diaz-Gomez, M. , Rei-Serra, T. and Jacome-Feijoo, R. (2012) Evaluation of participants' feedback after a simulation-based training in neonatal resuscitation using a realistic delivery room. Open Journal of Pediatrics, 2, 281-287. doi: 10.4236/ojped.2012.24047.

[1]   Perlman, J.M., Wyllie, J., Kattwinkel, J., Atkins, D.L., Chameides, L., Goldsmith, J.P., et al. (2010) On behalf of the neonatal resuscitation chapter collaborators. Part 11: Neonatal resuscitation: 2010 International consensus on cardiopulmonary resuscitation and emergency cardio-vascular Care science with treatment recommendations. Circulation, 122, S516-S538. doi:10.1161/CIRCULATIONAHA.110.971127

[2]   Knudson, M.M., Khaw, L., Bullard, M.K., Dicker, R., Cohen, M.J., Staudenmayer, K., et al. (2008) Trauma training in simulation: Translating skills from SIM time to real time. The Journal of Trauma, 64, 255-263. doi:10.1097/TA.0b013e31816275b0

[3]   Wayne, D.B., Didwania, A., Feinglass, J., Fudala, M.J., Barsuk, J.H. and McGaghie, W.C. (2008) Simulation-based education improves quality of care during cardiac arrest team responses at an academic teaching hospital: A case-control study. Chest, 133, 56-61. doi:10.1378/chest.07-0131

[4]   Brett-Fleeger, M.B., Vinvi, R.J., Weiner, D.L., Harris, S.K., Shih, M.C. and Kleinman, M.E. (2008) A simulator-based tool that asseses pediatric resident resuscitation competency. Pediatrics, 121, 597-603. doi:10.1542/peds.2005-1259

[5]   Schwid, H., Rooke, G., Ross, B. and Sivarajan, M. (1999) Use of a computerized advanced cardiac life support simulator improves retention of advanced cardiac life support guidelines better than a textbook review. Critical Care Medicine, 27, 821-824. doi:10.1097/00003246-199904000-00045

[6]   Kattwinkel, J., Perlman, J.M., Aziz, K., Colby, C., Fairchild, K., Gallagher, J., et al. (2010) Part 15: Neonatal resuscitation: 2010 American heart association guidelines for cardiopulmonary resuscitation and emergency cardio-vascular care. Circulation, 122, S909-S19. doi:10.1161/CIRCULATIONAHA.110.971119

[7]   Ziv, A., Wolpe, P.R., Small, S.D. and Glick, S. (2003) Simulation-based medical education: An ethical imperative. Academic Medicine, 78, 783-788. doi:10.1097/00001888-200308000-00006

[8]   Lynoe, N., Sandlund, M., Westberg, K. and Duchek, M. (1998) Informed consent in clinical training: Patient experiences and motives for participating. Medical Education, 32, 465-471. doi:10.1046/j.1365-2923.1998.00237.x

[9]   Perkins, G.D. (2007) Simulation in resuscitation training. Resuscitation, 73, 202-211. doi:10.1016/j.resuscitation.2007.01.005

[10]   Delasobera, B.E., Goodwin, T.L., Strehlow, M., et al. (2010) Evaluating the efficacy of simulators and multimedia for refreshing ACLS skills in India. Resuscitation, 81, 217-223. doi:10.1016/j.resuscitation.2009.10.013

[11]   Burke, C.S., Salas, E., Wilson-Donelly, K., Priest, H., et al. (2004) How to turn a team of experts into an expert medical team: Guidance from the aviation and military communities. Quality & Safety in Health Care, 13, 96-104. doi:10.1136/qshc.2004.009829

[12]   Shapiro, M.J., Morey, J.C., Small, S.D., Langford, V., Kaylor, C.J., Jagminas, L., et al. (2004) Simulation based teamwork training for emergency department staff: Does it improve clinical team performance when added to an existing didactic teamwork curriculum. Quality & Safety in Health Care, 13, 417-421. doi:10.1136/qshc.2003.005447

[13]   Cavaleiro, A.P., Guimaraes, H. and Calheiros, F.L. (2009) Training neonatal skills with simulators. Acta Paediatrica, 98, 636-639. doi:10.1111/j.1651-2227.2008.01176.x

[14]   Halamek, L.P., Kaegi, D.M., Gaba, D.M., Sowb, Y.A., Smith, B.C., Smith, B.E., et al. (2000) Time for a new paradigm in pediatric medical education: Teaching neonatal resuscitation in a simulated delivery room environment. Pediatrics, 106, 45-48. doi:10.1542/peds.106.4.e45

[15]   Southgate, W.M. and Annibale, D.J. (2010) Simulation training in graduate medical education. A means of traversing a changed and changing landscape. Advances in Neonatal Care, 5, 261-268. doi:10.1097/ANC.0b013e3181f08d38

[16]   Falucco, E.M., Hanson, M.D. and Glowinski, A.L. (2010) Teaching pediatric residents to assess adolescent suicide risk with a standardized patient module. Pediatrics, 125, 953-959. doi:10.1542/peds.2009-2135

[17]   Nadel, F.M., Lavelle, J.M., Fein, J.A., Giardino, A.P., Decker, J.M. and Durbin, D.R. (2000) Assessing pediatric senior residents training in resuscitation: Fund of know- ledge, technical skills, and perception of confidence. Pediatric Emergency Care, 16, 73-76. doi:10.1097/00006565-200004000-00001

[18]   Campbell, D.M., Barozzino, T., Farrugia, M. and Sgro M. (2009) High-fidelity simulation in neonatal resuscitation. Paediatrics & Child Health, 14, 19-23.

[19]   Rovamo, L., Mattila, M.M., Andersson, S. and Rosenberg, P. (2011) Assessment of newborn resuscitation skills of physicians with a simulator manikin. Archives of Disease in Childhood, 96, 383-389.

[20]   Halamek, L.P. (2008) The simulated delivery-room environment as the future modality for acquiring and maintaining skills in fatal and neonatal resuscitation. Seminars in Fetal and Neonatal Medicine, 13, 448-453. doi:10.1016/j.siny.2008.04.015

[21]   Soar, J., Monsieurs, K.G., Balance, J.H.W., et al. (2010) European resuscitation council guidelines for resuscitation 2010 section 9. Principles of education in resuscitation. Resuscitation, 81, 1434-1444. doi:10.1016/j.resuscitation.2010.08.014

[22]   Kattwinkel, J. and Perlman, J. (2010) The neonatal resuscitation program: The evidence evaluation process and anticipating edition 6. NeoReviews, 11, e673-e680.

[23]   Iriondo, M., Szydl, E., Vento, M., Burón, E., Salguero, E., Aguayo, J., et al. (2010) Changes in the international recommendations on neonatal resuscitation 2010: Com- ments. An Pediatr (Barc), in press.

[24]   Brilli, R.J., Spevezt, A., Branson, R.D., Campbell, G.M., Cohen, H., Dasta, J.F., et al. (2001) Critical care delivery in the intensive care unit: Defining clinical roles and the best practice model. Critical Care Medicine, 29, 207-219. doi:10.1097/00003246-200110000-00026

[25]   Sawyer, T., Hara, K., Thompson, M.W., Chan, D.S. and Berg, B. (2009) Modification of the laerdal simbaby to include an integrated umbilical cannulation task trainer. Simulation in Healthcare, 4, 174-178. doi:10.1097/SIH.0b013e31817bcaeb

[26]   Murphy, A.A. and Halamek, L.P. (2005) Simulation- based training in neonatal resuscitation. NeoReviews, 6, e489-e492. doi:10.1542/neo.6-11-e489

[27]   van der Heide, P.A., van Toledo-Eppinga, L. and van der Heide, M. (2006) Assessment of neonatal resuscitation skills: A reliable and valid scoring system. Resuscitation, 71, 212-221. doi:10.1016/j.resuscitation.2006.04.009

[28]   Lockyer, J., Singhal, N., Fidler, H., Weiner, G., Aziz, K. and Curran, V. (2006) The development of a perfomance checklist to assess neonatal resuscitation megacode skill. Pediatrics, 118, 1739-1744.