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NeoReviews Vol.6 No.11 2005 e489
© 2005 American Academy of Pediatrics

Educational Perspectives

Simulation-based Training in Neonatal Resuscitation

^* Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, Calif

The first 20% of the full text of this article appears below.

	Introduction

 
Some 100 million babies are born worldwide each year; 4 million in the United States alone. Approximately 10% of all newborns need some assistance to begin breathing at birth, and 1% require intensive resuscitative efforts such as endotracheal intubation and chest compressions. (1) Babies not receiving such timely help can die or suffer lifelong morbidity.

	Traditional and Emerging Training

 
Historically, training in neonatal resuscitation, as in most of medicine, has been accomplished by assuming graduated responsibility in the care of real patients. This apprenticeship model of medical education places a trainee in a supervised environment for a set period of time, with the expectation that guided experience will lead to acquisition of skills adequate enough for independent, competent practice in the community. Underlying this model is an assumption that the number and variety of cases experienced will be of sufficient depth and breadth to ensure competence at the close of the training period. Often, this is not the case. Thomas Krummel, MD, Chair, Department of Surgery, Stanford University, has termed this type of training "education by random opportunity."

The Accreditation Council for Graduate Medical Education, the body responsible for the accreditation of post-MD medical training programs in the United States, establishes program requirements for pediatric residency education. The program requirements state that the neonatal intensive care curriculum must be designed to teach resuscitation and care of newborns in the delivery room. These same guidelines, however, limit the time that pediatric residents can spend in a neonatal intensive care unit. (2) Investigations in anesthesia have shown that 40 to 60 intubation attempts are required for . . . [Full Text of this Article]