Just-In-Time Neonatal Endotracheal Intubation Simulation Training: A Randomized Controlled Trial.

J Pediatr

Division of Neonatology, Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC, Canada; Centre for Applied Health Sciences Education (CPASS), Faculty of Medicine, Université de Montréal, Montreal, QC, Canada; Centre Hospitalier Universitaire Sainte-Justine Research Center, Montreal, QC, Canada. Electronic address:

Published: October 2023

AI Article Synopsis

  • The study aimed to compare the effectiveness of simulation-based just-in-time training (JITT) versus a standard 5-minute video in teaching neonatal endotracheal intubation (ETI) skills to junior residents.
  • Results showed that while both training methods had similar overall success rates, the simulation-based JITT led to a higher success rate on the first attempt and required less time for attempts.
  • Although simulation-based JITT had some advantages, it also resulted in more mucosal trauma events, suggesting it should be used as a supplementary training method rather than a complete replacement.

Article Abstract

Objective: To assess if simulation-based just-in-time training (JITT, short video and simulation) is superior to video training (5-minute video) in acquiring skill in neonatal endotracheal intubation (ETI).

Study Design: A Canadian multicenter randomized trial recruited junior residents who performed neonatal ETI from July 2017 to June 2021. The primary outcomes were overall and first attempt ETI success rate. Secondary outcomes included number of attempts, duration of attempts, ETI-related complications, and residents' confidence level. Statistical analysis included generalized estimating equations, mixed model analysis, Mann-Whitney test, and χ² tests.

Results: Sixty-five residents performed 139 ETI. The overall success rate was similar for both groups (67% vs 70%, P = .71). However, the first attempt success rate was higher for the simulation-based JITT group (54% vs 41%, P = .035). The mean duration of attempts was shorter (35 [SD, 9] vs 62 [SD, 9] seconds, P = .048) and the median number of attempts had a tendency to be lower for the simulation-based JITT group (1 [IQR, 1; 1] vs 1 [IQR, 1; 2], P = .02). There were more mucosal trauma events in the simulation-based JITT group (P = .02). Residents in both groups reported similar confidence level in performing ETI.

Conclusions: Compared with video training, simulation-based JITT for neonatal ETI did not improve overall success rate. However, simulation-based JITT improved first attempt success rate and decreased the number and the duration of ETI attempts. With its positive clinical impact, simulation-based JITT can become an educational adjunct to neonatal ETI training for residents.

Trial Registration: ClinicalTrials.gov: NCT02809924.

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Source
http://dx.doi.org/10.1016/j.jpeds.2023.113576DOI Listing

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