title: Enhancing residents' neonatal resuscitation competency through unannounced simulation-based training.
abstract: BACKGROUND
  Almost half of pediatric third-year residents surveyed in 2000 had never led a resuscitation event. With increasing restrictions on residency work hours and a decline in patient volume in some hospitals, there is potential for fewer opportunities.
  
  
  OBJECTIVE
  Our primary purpose was to test the hypothesis that an unannounced mock resuscitation in a high-fidelity in-situ simulation training program would improve both residents' self-confidence and observed performance of adopted best practices in neonatal resuscitation.
  
  
  METHODS
  Each pediatric and medicine-pediatric resident in one pediatric residency program responded to an unannounced scenario that required resuscitation of the high fidelity infant simulator. Structured debriefing followed in the same setting, and a second cycle of scenario response and debriefing occurred before ending the 1-hour training experience. Measures included pre- and post-program confidence questionnaires and trained observer assessments of live and videotaped performances.
  
  
  RESULTS
  Statistically significant pre-post gains for self-confidence were observed for 8 of the 14 NRP critical behaviors (p=0.00-0.03) reflecting knowledge, technical, and non-technical (teamwork) skills. The pre-post gain in overall confidence score was statistically significant (p=0.00). With a maximum possible assessment score of 41, the average pre-post gain was 8.28 and statistically significant (p<0.001). Results of the video-based assessments revealed statistically significant performance gains (p<0.0001). Correlation between live and video-based assessments were strong for pre-post training scenario performances (pre: r=0.64, p<0.0001; post: r=0.75, p<0.0001).
  
  
  CONCLUSIONS
  Results revealed high receptivity to in-situ, simulation-based training and significant positive gains in confidence and observed competency-related abilities. Results support the potential for other applications in residency and continuing education.
authors.affiliation: Division of Neonatology, Department of Pediatrics, Louisiana State University Health Sciences Center-New Orleans, New Orleans, LA, USA. jsurco@lsuhsc.edu
authors.forename: Jeffrey W
authors.initials: JW
authors.lastname: Surcouf
authors.forename: Sheila W
authors.initials: SW
authors.lastname: Chauvin
authors.forename: Jenelle
authors.initials: J
authors.lastname: Ferry
authors.forename: Tong
authors.initials: T
authors.lastname: Yang
authors.forename: Brian
authors.initials: B
authors.lastname: Barkemeyer
mesh_terms: D002983:Clinical Competence; D003198:Computer Simulation; D004521:Educational Measurement; D006801:Humans; D007318:Inservice Training; D007363:Intensive Care Units, Neonatal; D007396:Internship and Residency / Q000379:methods*; D008348:Manikins; D010372:Pediatrics / Q000193:education*; D012151:Resuscitation / Q000193:education*; D020377:Self Efficacy
keywords: competency; neonatal resuscitation; pediatric residents; simulation-based training