Enhancing residents’ neonatal resuscitation competency through team-based simulation training: an intervention educational study

Abstract Background Neonatal resuscitation training in a simulated delivery room environment is a new paradigm in pediatric medical education. The purpose of this research is to highlight team-based simulation as an effective method of teaching neonatal resuscitation to senior pediatric residents. Methods In an intervention educational study, we evaluated the impact of team-based simulation training in the development of neonatal resuscitation. A team consisting of a three-person group of senior pediatric residents performed neonatal resuscitation on a low-fidelity newborn simulator based on the stated scenario. Video-based structured debriefing was performed and followed by the second cycle of scenario and debriefing to evaluate the feasibility of conducting team-based simulation training in a lesser-resourced environment. Evaluation criteria included megacode scores which is a simulation performance checklist, pre-and post-test scores to evaluate residents’ knowledge and confidence, the survey checklist as a previously developed questionnaire assessing residents’ satisfaction, and debriefing from live and videotaped performances. Four months after the end of the training course, we measured the behavioral changes of the residents by conducting an OSCE test to evaluate post-training knowledge retention. Mean ± SD was calculated for megacode, satisfaction (survey checklist), and OSCE scores. Pre- and post-program gains were statistically compared. The first three levels of Kirkpatrick’s training effectiveness model were used to evaluate the progress of the program. Results Twenty-one senior residents participated in the team-based simulation. The mean ± SD of the megacode score was 35.6 ± 2.2. The mean ± SD of the overall satisfaction score for the evaluation of the first level of the Kirkpatrick model was 96.3 ± 3.7. For the evaluation of the second level of the Kirkpatrick model, the pre-posttest gain in overall confidence score had a statistically significant difference (P = 0.001). All residents obtained a passing grade in OSCE as an evaluation of the third level. Conclusions Team-based simulation training in neonatal resuscitation improves the knowledge, skills, and performance of pediatric residents and has a positive effect on their self-confidence and leadership skills. There is still a need to investigate the transfer of learning and abilities to real-life practice, and further research on cost-effectiveness and impact on patient outcomes is warranted

Quality Assessment of Clinical Education in Mazandaran University of Medical Sciences from the Perspective of Clerkships and Interns in 2019

Background and purpose: Acquisition of basic skills and professionalism in medicine depends on the quality and quantity of education in clinical settings. This study aimed at assessing the quality of clinical education in different departments of Mazandaran University of Medical Sciences. Materials and methods: This descriptive study was conducted in medical clerkships and interns (n=175). The participants were selected via census sampling in 2019. Data were collected using a checklist based on clinical education standards of Iran Ministry of Health and Medical Education. Written comments from clerkships and interns on the compliance of morning report training programs, clinical trainings, clinical rounds, grand rounds, journal club, and clinical skills center with clinical training standards were received. Data analysis was performed in SPSS V16. Results: The morning report program and clinical skills center program had the highest (85.1%) and lowest (72.2%) scores in clinical education. We observed significant differences between these scores and the scores for other clinical programs (P>0.05). The quality of all clinical education programs was similar according to men and women. The clerkship and interns had different ideas about the status of all clinical education programs except in the morning report program and the clerkship were more satisfied with clinical education programs. Conclusion: From the students' point of view, the morning report program was of acceptable quality, but the clinical training programs, club journal, grand rounds, and clinical skills center had some drawbacks. Training workshops for clinical professors is recommended to enhance the standards of clinical training programs

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