Time for a new paradigm in pediatric medical education: Teaching neonatal resuscitation in a simulated delivery room environment

Objectives. Acquisition and maintenance of the skills necessary for success ful resuscitation of the neonate are typically accomplished by a combinatio n of completion of standardized training courses using textbooks, videotape , and manikins together with active participation in the resuscitation of h uman neonates in the real delivery room. We developed a simulation-based tr aining program in neonatal resuscitation (NeoSim) to bridge the gap between textbook and real life and to assess trainee satisfaction with the element s of this program. Methods. Thirty-eight subjects (physicians and nurses) participated in 1 of 9 full-day NeoSim programs combining didactic instruction with active, han ds-on participation in intensive scenarios involving life-like neonatal and maternal manikins and real medical equipment. Subjects were asked to compl ete an extensive evaluation of all elements of the program on its conclusio n. Results. The subjects expressed high levels of satisfaction with nearly all aspects of this novel program. Responses to open-ended questions were espe cially enthusiastic in describing the realistic nature of simulation-based training. The major limitation of the program was the lack of fidelity of t he neonatal manikin to a human neonate. Conclusion. Realistic simulation-based training in neonatal resuscitation i s possible using current technology, is well received by trainees, and offe rs benefits not inherent in traditional paradigms of medical education.