title: Deliberate practice improves pediatric residents' skills and team behaviors during simulated neonatal resuscitation.
abstract: OBJECTIVE
  To evaluate the skills and team behavior of pediatric residents during resuscitation with a high-fidelity mannequin before and after a deliberate practice intervention.
  
  
  METHODS
  Each month residents participate in two 90-minute videorecorded sessions (2-3 weeks apart) in an "off-site" delivery room during their neonatal ICU rotation. Teams responded to a scenario that required 5 skills (positive pressure ventilation, chest compressions, endotracheal intubation, umbilical vein catheterization, and epinephrine administration). Skills were scored for technique and timeliness and team behaviors for communication, management, and leadership. A 2-hour focused intervention was given between sessions.
  
  
  RESULTS
  In all, 33 residents (11 teams) completed the sessions. Gaps in procedural skills noted during the first session were corrected. Timeliness for completion of skills remained below expectations. Improvements in team behaviors were noted.
  
  
  CONCLUSIONS
  Deliberate practice improved procedural skills and team performance. Lack of improvement in timeliness suggests that a different educational paradigm is required.
authors.affiliation: Department of Pediatrics, The Wexner Medical Center, Ohio State University, Columbus, OH 43210-1228, USA. leandro.cordero@osumc.edu
authors.forename: Leandro
authors.initials: L
authors.lastname: Cordero
authors.forename: Brandon J
authors.initials: BJ
authors.lastname: Hart
authors.forename: Rene
authors.initials: R
authors.lastname: Hardin
authors.forename: John D
authors.initials: JD
authors.lastname: Mahan
authors.forename: Craig A
authors.initials: CA
authors.lastname: Nankervis
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003142:Communication; D004503:Education, Medical, Graduate / Q000379:methods*; D004521:Educational Measurement; D005260:Female; D006801:Humans; D007363:Intensive Care Units, Neonatal; D007396:Internship and Residency; D007400:Interprofessional Relations; D008297:Male; D008348:Manikins; D010348:Patient Care Team / Q000458:organization & administration; D010372:Pediatrics / Q000193:education; D058996:Quality Improvement; D012151:Resuscitation / Q000193:education*
keywords: deliberate practice; neonatal resuscitation; simulation