Simulation for Neonatal Endotracheal Intubation Training: How Different Is It From Clinical Practice?

Authors

Lamia M. Soghier, From the Department of Neonatology (L.M.S.), and Center for Translational Science (L.M.S., K.R.F.), Children's Research Institute, Children's National Hospital; The George Washington University School of Medicine and Health Sciences (L.M.S., E.F.G., K.R.F.); Simulation Program (H.A.W.), Children's National Hospital; The George Washington University Graduate School of Education and Human Development (E.F.G.); and Division of General and Community Pediatrics (K.R.F.), Children's National Hospital, Washington, DC.
Heather A. Walsh
Ellen F. Goldman
Karen R. Fratantoni

Document Type

Journal Article

Publication Date

2-1-2022

Journal

Simulation in healthcare : journal of the Society for Simulation in Healthcare

Volume

17

Issue

1

DOI

10.1097/SIH.0000000000000551

Abstract

INTRODUCTION: Neonatal endotracheal intubation is a critical skill that is difficult for learners to acquire even with simulation-based training (SBT). Trainees prefer clinical experiences over SBT. The objective of the study was to explore the differences between SBT and clinical practice in acquiring neonatal intubation skills to inform mannequin design and to improve fidelity. METHODS: A basic qualitative study using semistructured interviews was conducted to determine the experience of newly competent trainees (second- and third-year neonatal-perinatal medicine fellows) and their instructors in developing intubation skills. Participants were asked to compare learning through SBT with clinical practice in terms of context, equipment, and environment. Their responses were analyzed using an inductive approach. RESULTS: Thirty-two participants (20 fellows and 12 faculty) indicated that SBT does not equal the real experience. Specifically, the look, feel, and function of the simulators differ enough from the real patient and the clinical environmental that they do not elicit the desired learning responses. The clinical environment prompted heightened emotions and had a chaotic atmosphere that was not fully captured by SBT. Participants suggested that programs use SBT in the initial phases of training only to gain basic skills and they provided several solutions for mannequin and SBT session design. CONCLUSIONS: Simulation-based training does not fully prepare neonatal-perinatal medicine fellows for neonatal intubation. Mannequins with unique active features, such as multiple airway configurations, slipperiness, secretions, and softer textures should be developed. Realistic environments that replicate the interprofessional nature and stressors of the clinical environment might better prepare learners for the complexity of clinical practice.

APA Citation

Soghier, Lamia M.; Walsh, Heather A.; Goldman, Ellen F.; and Fratantoni, Karen R., "Simulation for Neonatal Endotracheal Intubation Training: How Different Is It From Clinical Practice?" (2022). GW Authored Works. Paper 392.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/392

Department

Pediatrics