Weekly and consecutive day neonatal intubation training: comparable on a pediatrics clerkship.
OBJECTIVE
To determine whether medical student intubation proficiency with a neonatal mannequin differs according to weekly or consecutive day practice sessions during a six-week pediatric clerkship.


METHODS
From July 2010 through June 2011, the authors prospectively randomized 110 third-year medical students into three neonatal intubation practice groups: standard (control; no practice sessions), weekly (practice once/week for four consecutive weeks), or consecutive day (practice once/day for four consecutive days). At baseline, students performed intubation during individual sessions using a neonatal mannequin (SimNewB). Two reviewers, blinded to practice group, viewed videotapes of intubations and independently scored students on equipment selection, procedural skill steps, length of intubation attempts (in seconds), and the number of attempts (up to three) needed for a successful intubation. Videotaped individual final assessment intubation sessions during week six were evaluated in the same manner.


RESULTS
Students in the weekly and consecutive day practice groups performed better at the final assessment on all variables than students in the standard group (P < .001), but over six weeks, the authors detected no differences between the two distributed practice formats for any outcomes of interest.


CONCLUSIONS
Practice improved all aspects of neonatal intubation performance, including choosing the correct equipment, properly performing the skill steps, length of time to successful intubation, and success rate, for novice health care providers in a simulation setting. Over six weeks, neither practice format proved superior, but it remains unclear whether one format is superior for learning and skill retention over the long term or in actual practice.
Dr. Ernst is associate professor and director of medical education in newborn medicine, Department of Pediatrics, Division of Neonatal-Perinatal Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma. Dr. Cline was, at the time of this study, neonatology fellow, Department of Pediatrics, Division of Neonatal-Perinatal Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, and she is currently a clinical neonatologist in private practice, CoxHealth South, Springfield, Missouri. Dr. Dannaway is assistant professor and assistant director, Neonatal Fellowship Program, Department of Pediatrics, Division of Neonatal-Perinatal Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma. Ms. Davis is a graduate student, Division of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma. Dr. Anderson is assistant professor and statistician, Division of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma. Dr. Atchley was, at the time of this study, neonatology fellow, and she is currently assistant professor, Department of Pediatrics, Division of Neonatal-Perinatal Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma. Dr. Thompson is assistant dean for medical education and is affiliated with the Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
Kimberly D
KD
Ernst
Whitney L
WL
Cline
Douglas C
DC
Dannaway
Erin M
EM
Davis
Michael P
MP
Anderson
Courtney B
CB
Atchley
Britta M
BM
Thompson
D002982:Clinical Clerkship / Q000379:methods*; D002983:Clinical Competence; D004504:Education, Medical, Undergraduate / Q000379:methods*; D006801:Humans; D007231:Infant, Newborn; D007442:Intubation, Intratracheal; D008348:Manikins; D010372:Pediatrics / Q000193:education*; D011446:Prospective Studies; D013997:Time Factors