Gupta Arika G, Trivedi Shamik B, Smith Shawn M, McBride Mary E, Adler Mark D
Division of Neonatology, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, USA.
Division of Hospital Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, USA.
Cureus. 2025 Jul 3;17(7):e87239. doi: 10.7759/cureus.87239. eCollection 2025 Jul.
To design and implement a simulation-based mastery learning (SBML) curriculum utilizing deliberate practice (DP) for neonatal intubation in the delivery room setting. We sought to investigate the impact this curriculum would have on performance and skill retention.
A prospective single-group SBML with DP intervention to improve intubation success was implemented from 2019 to 2022. Pediatric hospitalists (PHs) and neonatal nurse practitioners (NNPs) who provide care in the delivery room were eligible to participate. An 11-item checklist was developed, and a minimum passing standard (MPS) was set using the Mastery Angoff method. Participants underwent a baseline assessment, followed by DP with expert feedback. Post-intervention assessments were completed until the MPS was achieved, with additional practice rounds if needed. After three to six months, all participants underwent a retention assessment. If MPS was not achieved at retention, further DP was provided until MPS was met.
At the time of enrollment, 95% of participants had limited experience with attempted neonatal intubation (less than five performed), and 14% had never attempted an actual neonatal intubation. At baseline assessment, 95% of participants did not meet the MPS. Participants' mean scores significantly improved on the intubation checklist from 74% to 99% from baseline to post-training assessment. The intervention was significant and impactful, with effect sizes of >2. At the three-to-six-month retention assessment, 66% of participants met the MPS on the first attempt. Overall, 92% reported an increased confidence level with the procedure and an improvement in their clinical practice.
Our SBML with DP neonatal intubation curriculum is an effective tool to train providers in neonatal intubation for the delivery room environment. As clinical opportunities to learn this procedure continue to decline, programs must develop ways to optimize proficiency in this skill.
设计并实施一种基于模拟的掌握学习（SBML）课程，该课程利用刻意练习（DP）在产房环境中进行新生儿插管操作。我们试图研究该课程对操作表现和技能保持的影响。
2019年至2022年实施了一项采用DP干预以提高插管成功率的前瞻性单组SBML。在产房提供护理服务的儿科住院医师（PHs）和新生儿执业护士（NNPs）有资格参与。制定了一份11项的检查表，并使用掌握安格夫方法设定了最低及格标准（MPS）。参与者先进行基线评估，然后接受有专家反馈的DP。进行干预后评估，直到达到MPS，如有需要可进行额外的练习轮次。三到六个月后，所有参与者进行保持评估。如果在保持评估时未达到MPS，则提供进一步的DP，直到达到MPS。
在入组时，95%的参与者尝试新生儿插管的经验有限（操作次数少于5次），14%的参与者从未尝试过实际的新生儿插管。在基线评估时，95%的参与者未达到MPS。从基线评估到训练后评估，参与者在插管检查表上的平均得分从74%显著提高到99%。该干预具有显著且有效的影响，效应量>2。在三到六个月的保持评估中，66%的参与者在首次尝试时达到了MPS。总体而言，92%的参与者报告对该操作的信心增强，临床实践有所改善。
我们的带有DP的SBML新生儿插管课程是在产房环境中培训医护人员进行新生儿插管的有效工具。随着学习该操作的临床机会不断减少，各项目必须开发方法来优化这项技能的熟练程度。
