Agrawal Sachin, Rakshasbhuvankar Abhijeet, Rath Chandra, Brown Janie A, McEvoy Peter M, Rao Shripada, Patole Sanjay
School of Medicine, University of Western Australia, Crawley, WA, Australia.
King Edward Memorial Hospital for Women, Subiaco, WA, Australia.
Pediatr Res. 2025 Jun 17. doi: 10.1038/s41390-025-04217-4.
Acquiring skills for neonatal endotracheal intubation (ETI) has become difficult for trainees due to decreased opportunities following the increased use of non-invasive respiratory support. Recent studies report very low rates of successful first-attempt ETI in neonates despite current educational strategies. Hence, novel approaches for coaching the trainees to become procedurally competent are urgently required.
A comprehensive literature review of PubMed, Embase, Emcare, CINAHL, and Cochrane Library databases was conducted in January 2025 to identify evidence-based strategies to improve neonatal ETI skills. A multidisciplinary approach was taken for integrating stress-management skills in the educational program.
Video-laryngoscopy aided coaching, Just-in-time training, frequent practice on mannequins, rapid cycle deliberate practice, mental skills training, and deep-slow breathing were identified as appropriate strategies for inclusion in the educational program. Based on the principles of micro-credentialing, a comprehensive educational program was developed.
Our innovative educational program focuses on enhancing procedural skills for neonatal ETIs and reducing acute stress response in trainees while performing the procedure. Well-designed studies are needed to evaluate the impact of the program on patient outcomes and trainee wellbeing. Whilst primarily aimed at trainees, even senior fellows, consultants and nursing staff can use it to maintain their skills.
Our program facilitates coaching of trainees in neonatal endotracheal intubation skills. It provides feasible solutions to attenuate stress while performing the procedure. Whilst primarily aimed at trainees, even senior clinicians can use it. The program has the potential to improve patient safety and trainee wellbeing. It can be adopted for other high-acuity low-occurrence (HALO) clinical procedures.
由于无创呼吸支持的使用增加，培训学员获得新生儿气管插管（ETI）技能变得困难。最近的研究报告称，尽管有当前的教育策略，但新生儿首次尝试ETI成功的比例非常低。因此，迫切需要新的方法来指导学员在操作上达到胜任水平。
2025年1月对PubMed、Embase、Emcare、CINAHL和Cochrane图书馆数据库进行了全面的文献综述，以确定提高新生儿ETI技能的循证策略。采用多学科方法将压力管理技能纳入教育计划。
视频喉镜辅助指导、即时培训、在模型上频繁练习、快速循环刻意练习、心理技能训练和深呼吸被确定为适合纳入教育计划的策略。基于微认证原则，制定了一个全面的教育计划。
我们创新的教育计划侧重于提高新生儿ETI的操作技能，并减少学员在操作过程中的急性应激反应。需要精心设计的研究来评估该计划对患者结局和学员健康的影响。虽然该计划主要针对学员，但即使是高级研究员、顾问和护理人员也可以使用它来保持他们的技能。
我们的计划有助于指导学员掌握新生儿气管插管技能。它提供了在操作过程中减轻压力的可行解决方案。虽然主要针对学员，但即使是资深临床医生也可以使用它。该计划有可能提高患者安全和学员健康水平。它可用于其他高风险低发生率（HALO）的临床操作。
