title: Benefits of simulation based training for neonatal resuscitation education: a systematic review.
abstract: BACKGROUND
  Simulation-based training (SBT) is being more frequently recommended for neonatal resuscitation education (NRE). It is important to assess if SBT improves clinical outcomes as neonatal resuscitation aims to improve survival without long-term neurodevelopmental impairment. We aimed to assess the evidence supporting benefits of SBT in NRE.
  
  
  METHODS
  A systematic review was conducted using the Cochrane methodology. PubMed, Embase, PsycInfo and Cochrane databases were searched. Related abstracts were scanned and full texts of the potentially relevant articles were studied. Randomised controlled trials (RCT) and quasi-experimental studies with controls (non-RCT) assessing SBT for NRE were eligible for inclusion in the review.
  
  
  RESULTS
  Four small studies [three RCT (n=126) and one non-RCT (n=60)] evaluated SBT for NRE. Participants included medical students (one RCT and one non-RCT), residents (one RCT) and nursing staff (one RCT). Outcomes included performance in a simulation scenario, theoretical knowledge, and confidence in leading a resuscitation scenario. One RCT favoured simulation [improved resuscitation score (p=0.016), 2.31 more number of critical actions (p=0.017) and decreased time to achieve resuscitation steps (p=<0.001)]. The remaining two RCTs and the non-RCT did not find any difference between SBT and alternate methods of instruction. None of the four studies reported clinical outcomes.
  
  
  CONCLUSIONS
  Evidence regarding benefits of SBT for NRE is limited. There are no data on clinical outcomes following SBT for NRE. Large RCTs assessing clinically important outcomes are required before SBT can be recommended widely for NRE.
authors.affiliation: Department of Neonatal Paediatrics, King Edward Memorial Hospital for Women, Perth, Australia. Electronic address: abhijeet.rakshasbhuvankar@health.wa.gov.au.
authors.forename: A A
authors.initials: AA
authors.lastname: Rakshasbhuvankar
authors.affiliation: Department of Neonatal Paediatrics, King Edward Memorial Hospital for Women, Perth, Australia; Centre for Neonatal Research and Education, University of Western Australia, Perth, Australia.
authors.forename: S K
authors.initials: SK
authors.lastname: Patole
mesh_terms: D006801:Humans; D007231:Infant, Newborn; D008348:Manikins; D012151:Resuscitation / Q000193:education*
keywords: Infant, Newborn; Resuscitation, Training, Systematic review; Simulation