Deliberate practice using simulation improves neonatal resuscitation performance.

INTRODUCTION: Simulation will soon become the standard method of training in the Neonatal Resuscitation Program (NRP). Deliberate practice (DP) using simulation has been shown to improve performance in other areas of medicine. The objective of this study was to evaluate the effectiveness of DP using simulation on improving NRP performance.

METHODS: Using a pretest-posttest design, 15 teams of 2 residents participated in a series of 3 NRP simulations followed by a facilitated debriefing. Objective measures of NRP performance and time to complete critical tasks were evaluated on the first (pretest) and the third (posttest) simulations by blinded video review using a validated scoring instrument.

RESULTS: Improvements were seen in scores for overall NRP performance (pretest 82.5% vs. posttest 92.5%, mean difference 10% [95% CI, 1.5-18.5]; P = 0.024) and positive-pressure ventilation (pretest 73.3% vs. posttest 95.0%, mean difference 21.7% [95% CI, 0.8-42.5]; P = 0.043). Time to the vascular access decreased by over 1 minute from baseline (pretest 404 second vs. posttest 343 second, mean difference -60.3 second [95% CI, -119.6 to -0.9]; P = 0.047) as did the time to first IV medication (pretest 452 second vs. posttest 387 second, mean difference -64.9 second [95% CI, -112.4 to -17.5]; P = 0.011).

CONCLUSIONS: Our results suggest that DP using simulation is associated with improvements in NRP performance and support the use of DP using simulation in NRP training.