Clinical Fellow University of Pittsburgh School of Medicine Pittsburgh, Pennsylvania, United States
Background: Pediatricians provide the majority of delivery room care, with 10% of infants requiring resuscitation at birth. Pediatric trainees must be prepared to perform life-saving skills outlined by the Neonatal Resuscitation Program (NRP). However, many residents do not achieve necessary competencies by graduation. We aim to describe a sustainable curricular intervention leveraging the skills of clinical fellows to enhance pediatric residents' neonatal resuscitation knowledge and skills. Objective: The goal of this curricular intervention is to improve pediatric residents’ quantitative procedural performance, measured using a procedural performance checklist. Secondary outcomes include enhanced knowledge on key neonatal topics and qualitative perceptions of educational experience during their neonatology rotation. Design/Methods: Pediatric residents were quasi-randomized based on their rotation month to curricular intervention or control groups during their second neonatal intensive care rotation. A pre/post test design was used to compare each residents performance at the start and end of rotation. Control residents received standard teaching from faculty. In addition to standard teaching, intervention residents received weekly didactics paired with simulation training by a fellow. To assess the primary outcome, we created a procedural performance checklist based on the NRP algorithm to score resident performance during a simulated resuscitation of a premature infant. A composite score was calculated, as well as sub-scores of preparation, positive pressure ventilation, corrective steps, endotracheal intubation, and compressions/medications. A case-based knowledge test was created to assess understanding of neonatal topics. Finally, residents were surveyed regarding their learning environment, including satisfaction with didactic and simulation training. Descriptive analyses of each domain (skills, knowledge and attitudes) were performed with Student’s t-test used to compare between group differences. This study was approved by the University of Pittsburgh Medical Center IRB.
