Health Sciences Education Symposium
Presentation Format
Poster
Type of Activity
Innovation
Original Presentation Date
2023
Date of Submission
March 2023
Abstract/Short Description
Purpose and background, including relevant citations: All pediatric residents are required to rotate through the neonatal intensive care unit (NICU). The NICU is a unique unit that provides care for premature and ill neonates. At Children’s Hospital of Richmond at VCU (CHOR VCU), pediatric residents complete 12 weeks in the NICU, 4 weeks each year. As a part of this rotation, these residents are responsible for attending high risk deliveries. At birth about 10% of neonates will require resuscitation (1). Before starting residency, each resident is required to complete the neonatal resuscitation program (NRP). This certification requires renewal every two years. NRP conveys an evidence based approach to the care of the newborn at birth, and is the standard of care in the USA for healthcare professionals who manage newborns in the hospital (2). Studies have shown that retention of skills learned in certification courses such as NRP last 6-12 months (3). Due to when residents are scheduled, they can sometimes go longer than 12 months between rotations in the NICU, therefore they have limited opportunity to maintain their NRP skills with frequent recurrent practice. This has implications not only to the capabilities of the senior residents to feel competent to provide neonatal resuscitation, but also as they must feel competent to contribute to the education and supervision of pediatric interns.
Description of Innovative Practice: Implement a self-paced adult learning NICU resident curriculum. The first part of the curriculum is online based with readings and questions. The topics include high yield pathologies that are seen in the NICU everyday. The second part will be NRP simulations conducted twice during their two-week rotations, one at the beginning to refresh NRP skills and a second simulation including practicing placement of umbilical venous catheter lines. The goal of this project is to help pediatric residents have a better understanding of the pathology seen in the NICU and to maintain their NRP competency and prevent NRP skill deterioration over time.
Results: This is a new curriculum that is just being enrolled so we do not currently have results.
Conclusion, including reflective critique, and next steps for research: Moving forward we will start collecting surveys pre rotation and post rotation. Following PDSA cycles, we will look through the data every three months and implement change where indicated based on survey results to improve the practice. As part of this project, we plan to create a refresher video on the basics of NRP that will be available to all residents at any time for their own review.
References
1. Wyckoff MH, Aziz K, Escobedo MB, Kapadia VS, Kattwinkel J, Perlman JM, Simon WM, Weiner GM, Zaichkin JG. Part 13: Neonatal Resuscitation: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2015 Nov 3;132(18 Suppl 2):S543 60. doi : 10.1161/CIR.0000000000000267. PMID: 26473001
2. Zaichkin J, Kamath Rayne BD, Weiner G. The NRP 8th Edition: Innovation in Education. Neonatal Netw . 2021 Jul 1;40(4):251 261. doi : 10.1891/11 T 756. PMID: 34330875.
3. Murphy A, Halamek L. Simulation based training in neonatal resuscitation. Neoreviews 2005; 11: e48991.
4. Halamek LP, Kaegi DM, Gaba DM, Sowb YA, Smith BC, Smith BE, Howard SK. Time for a new paradigm in pediatric medical education: teaching neonatal resuscitation in a simulated delivery room environment. Pediatrics. 2000 Oct;106(4):E45. doi : 10.1542/peds.106.4.e45. PMID: 11015540.
5. Surcouf JW, Chauvin SW, Ferry J, Yang T, Barkemeyer B. Enhancing residents' neonatal resuscitation competency through unannounced simulation based training. Med Educ Online. 2013 Mar
Rights
© The Author(s)
Is Part Of
VCU Medical Education Symposium
First Author Information
Kelly Stanley MD, Neonatal Perinatal Medicine Children’s Hospital of Richmond at Virginia Commonwealth University, VCU School of Medicine