492 - Development of a Simulation-Based Neonatal Intubation Procedure Curriculum for Pediatric Residents

Monday, May 1, 2023

9:30 AM – 11:30 AM ET

Poster Number: 492
Publication Number: 492.422

Blair Welch, Riley Hospital for Children at Indiana University Health, Indianapolis, IN, United States; Sara K. Kane, Riley Hospital for Children at Indiana University Health, Indianapolis, IN, United States

Presenting Author(s)

Blair Welch, MD (she/her/hers)

Neonatology Fellow
Riley Hospital for Children at Indiana University Health
Riley Hospital for Children at Indiana University Health
Indianapolis, Indiana, United States

Background: The ACGME requires pediatric residents develop competency in 14 procedures, yet studies demonstrate that recent graduates are completing training without this recommended procedural competency.

Objective: To perform a needs assessment evaluating the current state of Indiana University (IU) pediatric resident competency in performing neonatal intubations and to develop an educational curriculum for this procedure.

Design/Methods: We designed two surveys, one sent to pediatric residents, and one sent to faculty and fellows who supervise resident procedures. We then developed a simulation-based procedure curriculum which began in July 2022. The curriculum includes a lecture and procedural instruction with practice on a simulation manikin. A 5-point quiz is administered to residents before and after curriculum participation to provide knowledge-based curriculum assessment. Prior to receiving instruction, residents are asked to perform the procedure on the manikin as a baseline evaluation of procedural skill. The sessions are complete when residents perform all steps of the procedure correctly and in order. Residents then perform the procedure on the manikin 2-3 months later to evaluate for skill retention.

Results: A total of 31 pediatric residents (20%) and 22 neonatology faculty and fellows (55%) responded to the survey. Over half of respondents from both groups rated neonatal intubation competence as ≥8 on a 10-point scale of importance and both groups felt that simulation was an important tool in the development of procedural competency (Figure 1). Two-thirds of residents reported either 1 previous patient attempt or had never attempted the procedure on a patient. 59% of supervisors and 71% of residents felt that less than half of graduating residents were competent to perform neonatal intubations (Figure 2). 26 residents have completed the neonatal intubation curriculum to date. Knowledge-based quiz scores improved following the curriculum sessions with a median score of 3.5 (IQR 3, 4) on the pre-test and a median score of 4 (IQR 4, 5) on the post-test (Figure 3). The median baseline procedure checklist score was 7 out of 10 (IQR 6, 9), with 65% able to perform the procedure successfully on the manikin within 30 seconds. Re-evaluations are ongoing to assess procedural skill retention.

Conclusion(s): Residents and supervisors felt that neonatal intubation procedural competence was important for pediatric residents, but most felt that graduating residents were not competent to perform this procedure. To address this issue, we developed a curriculum to improve procedural knowledge and competency.