Simulation in neonatal care: towards a change in traditional training?

Abstract

Simulation has traditionally been used in neonatal medicine for educational purposes which include training of novice learners, maintaining competency of health care providers, and training of multidisciplinary teams to handle crisis situations such as neonatal resuscitation. Current guidelines recommend the use of simulation as an education tool in neonatal practice. The place of simulation-based education has gradually expanded, including in limited resource settings, and is starting to show its impact on improving patient outcomes on a global basis. Over the past years, simulation has become a cornerstone in clinical settings with the goal of establishing high quality, safe, reliable systems. The aim of this review is to describe neonatal simulation training as an effective tool to improve quality of care and patient outcomes, and to encourage the use of simulation-based training in the neonatal intensive care unit (NICU) for not only education, but equally for team building, risk management and quality improvement.

Conclusion: Simulation is a promising tool to improve patient safety, team performance, and ultimately patient outcomes, but scarcity of data on clinically relevant outcomes makes it difficult to estimate its real impact. The integration of simulation into the clinical reality with a goal of establishing high quality, safe, reliable, and robust systems to improve patient safety and patient outcomes in neonatology must be a priority.

What is known: • Simulation-based education has traditionally focused on procedural and technical skills. • Simulation-based training is effective in teaching non-technical skills such as communication, leadership, and teamwork, and is recommended in neonatal resuscitation.

What is new: • There is emerging evidence for the impact of simulation-based training on patient outcomes in neonatal care, but data on clinically relevant outcomes are scarce. • Simulation is a promising tool for establishing high quality, safe, reliable, and robust systems to improve patient safety and patient outcomes.

Keywords: Education; Neonatal care; Newborn; Quality improvement; Resuscitation; Simulation; Teamwork.

Fig. 1

© 2021 Premasim, Romain Moreau. All rights reserved. With permission. Photos from Premasim, an in situ simulation program at the APHP Paris Saclay University NICU in Paris. A A low technology mannequin (Premature Anne™) and clinical equipment from the NICU are used to create a realistic experience for learners. B Ongoing scenario with a multiprofessional team. C Low cost “icebreakers.” Plastic cups with sweets covered with various slogans are used to facilitate briefing and debriefing. D Debriefing