title: Interdisciplinary onsite team-based simulation training in the neonatal intensive care unit: a pilot report.
abstract: Simulation training improves individual clinician confidence, performance and self-efficacy in resuscitation and procedural training experiences. The reality of resuscitation experiences in the neonatal intensive care unit (NICU) is that they are team-accomplished events. However, limited data exist on team-based simulation training (TBST) in the NICU. We report the experience of TBST over a 4-year period.
  
  
  
  This is a retrospective report of 65 TBST events in a 71-bed Level IV NICU at a regional subspecialty children's hospital. Participants were more than 500 NICU staff, including neonatal/cardiac/surgical attendings, neonatal fellows, neonatal nurse practitioners, pediatric residents, registered nurses and respiratory therapists. Background work, common case scenarios, training objectives and learning opportunities were reported, along with discipline-specific, and team and system areas for improvement. Qualitative, subjective data were tracked and efforts at collecting quantitative, objective data are ongoing.
  
  
  
  Seventy-five TBST events were scheduled from November 2010 through December 2014; 10 of these were canceled. TBST events occurred both night (n=23) and day (n=42), and also on weekends (n=19), using high-fidelity (n=42) and low-fidelity (n=23) systems. Resuscitation team participants at each TBST were 12-30 providers and staff. The duration of each TBST event was 30-65 min including debriefing. Systems issues were identified and corrected, including problems activating the code pathway, issues using a pager activation system and confusion over resuscitation team roles and responsibilities. Educational needs were addressed, focused on topic areas that included arrhythmias and use of extracorporeal cardiopulmonary resuscitation.
  
  
  
  With appropriate planning and implementation, TBST is feasible and realistic in a busy NICU.
authors.affiliation: Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO, USA.|University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA.
authors.forename: D J W
authors.initials: DJW
authors.lastname: Reed
authors.affiliation: Department of Nursing, Children's Mercy Kansas City, Kansas City, MO, USA.
authors.forename: R L
authors.initials: RL
authors.lastname: Hermelin
authors.affiliation: Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO, USA.|University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA.
authors.forename: C S
authors.initials: CS
authors.lastname: Kennedy
authors.affiliation: Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO, USA.|University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA.
authors.forename: J
authors.initials: J
authors.lastname: Sharma
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D006776:Hospitals, Pediatric; D006801:Humans; D007363:Intensive Care Units, Neonatal; D008923:Missouri; D009359:Neonatology / Q000191:economics*; D010348:Patient Care Team / Q000592:standards*; D010865:Pilot Projects; D012151:Resuscitation / Q000193:education*; D012189:Retrospective Studies; D000066908:Simulation Training / Q000379:methods / Q000706:statistics & numerical data*