253 - Adapting to a Decrease in NICU Resident Rotation Duration with an ABP-Topic Specific Simulation Curriculum

Poster Number: 253
Publication Number: 253.330

Aaron M. Germain, Johns Hopkins All Children's Hospital, Tampa, FL, United States; Joana Machry, Johns Hopkins All Children's Hospital, Saint Petersburg, FL, United States

Background: Pediatric residency training has evolved to include less cumulative neonatal intensive care unit (NICU) rotation experience. Simulation has emerged as an innovative approach to many aspects of medical education. In response to changes in the structure of our pediatric residency’s NICU rotation, including reduction of the duration of the first-year resident’s rotation to three weeks, asynchronous with the second-year resident’s rotation of six weeks, we designed a cyclical topic-based simulation curriculum to meet learning objectives of both the intern and senior resident learners.

Objective: Adapt to a decrease in pediatric residency NICU rotation duration with an ABP-topic specific rotation simulation curriculum and assess.

Design/Methods: We piloted a resident NICU simulation course designed to complement a comprehensive curriculum based on the ABP topic specifications for Fetal and Neonatal Care. The simulation curriculum was adapted to the asynchronous schedules of first- and second-year residents by incorporating two 3-week cycles of weekly simulations within the 6-week course. Each cycle begins with a delivery room-based resuscitation, followed by two NICU-based resuscitation/stabilization scenarios. Emphasis was placed on team-based skills including coordination of technical skills and effective communication. Resident learners voluntarily completed an anonymous pre- and post-simulation 5-point Likert scale assessment distributed electronically via Qualtrics. Assessments were analyzed with two-sample t-Tests.

Results: 54 simulation scenario learning experiences were completed by 12 residents (6 first-year and 6 second-year residents; Figure 1 and Table 1). All residents perceived improved understanding of the diagnoses/pathologies following participation in the simulation series (p < 0.0001). All residents perceived greater confidence in performing team-based resuscitation/stabilization skills following participation in the simulation series (p < 0.0001). There was no statistically significant difference in first-year versus second-year resident assessments.    Conclusion(s): In addition to the demonstrated effectivity of mastering clinical and technical skills, participation in a clinical simulation scenario curriculum may be useful to enhance adult learner engagement in topic-specific learning as part of a comprehensive pediatric residency NICU rotation curriculum. We present an adapted model for a pediatric residency NICU rotation simulation curriculum designed to address the needs of both the inexperienced and senior learners, variations of which may be generalized to other programs.   
Figure 1: NICU Resident Rotation Simulation Curriculum
Table 1: Simulation Learner Evaluations(5-point Likert scale)