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PEDIATRICS Vol. 106 No. 4 October 2000, p. e45

ELECTRONIC ARTICLE:
Time for a New Paradigm in Pediatric Medical Education: Teaching Neonatal Resuscitation in a Simulated Delivery Room Environment

Received Jan 26, 2000; accepted May 26, 2000.

Louis P. Halamek*, David M. Kaegi*, David M. GabaDagger , Yasser A. SowbDagger , Bradford C. Smith*, Brian E. SmithDagger , and Steven K. HowardDagger

From the Departments of * Pediatrics and Dagger  Anesthesiology, Stanford University School of Medicine, Stanford, California, and Patient Safety Center of Inquiry at VA Palo Alto, Health Care System, Palo Alto, California.

Objectives.  Acquisition and maintenance of the skills necessary for successful resuscitation of the neonate are typically accomplished by a combination of completion of standardized training courses using textbooks, videotape, and manikins together with active participation in the resuscitation of human neonates in the real delivery room. We developed a simulation-based training program in neonatal resuscitation (NeoSim) to bridge the gap between textbook and real life and to assess trainee satisfaction with the elements of this program.

Methods.  Thirty-eight subjects (physicians and nurses) participated in 1 of 9 full-day NeoSim programs combining didactic instruction with active, hands-on participation in intensive scenarios involving life-like neonatal and maternal manikins and real medical equipment. Subjects were asked to complete an extensive evaluation of all elements of the program on its conclusion.

Results.  The subjects expressed high levels of satisfaction with nearly all aspects of this novel program. Responses to open-ended questions were especially enthusiastic in describing the realistic nature of simulation-based training. The major limitation of the program was the lack of fidelity of the neonatal manikin to a human neonate.

Conclusion.  Realistic simulation-based training in neonatal resuscitation is possible using current technology, is well received by trainees, and offers benefits not inherent in traditional paradigms of medical education.  Key words:  neonatal resuscitation, simulation, medical education.




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