487 - ENCORE: Establishing NRP Curriculum for Ongoing Resident Education

Publication Number: 487.5023

Alexandrine Ratnani, University of Virginia School of Medicine, Charlottesville, VA, United States; Jaclyn Wiggins, University of Virginia School of Medicine, Charlottesville, VA, United States; Brooke D. Vergales, University of Virginia School of Medicine, Charlottesville, VA, United States

Background: Each year in the U.S., about 10% of neonates require resuscitation at birth, making neonatal resuscitation a critical skill. Pediatric residents receive neonatal resuscitation training through the Neonatal Resuscitation Program (NRP) before starting residency and biennially thereafter. However, many residents finish their training lacking sufficient knowledge and procedural competency due to the absence of a formal curriculum.

Objective: Implement a curriculum that enhances pediatric residents' knowledge, skills, and confidence in neonatal resuscitation.

Design/Methods: A novel curriculum was implemented to augment pediatric residents’ neonatal resuscitation skills through guided instruction and simulation during each NICU rotation. Between July 2022 and June 2023, 20 pediatric residents participated in the curriculum, with 12 interns rotating through the NICU twice during the year. On the first day of each rotation, residents completed a pre-test with multiple-choice questions on neonatal resuscitation and a survey assessing their confidence in neonatal resuscitation. They then reviewed NRP guidelines and practiced resuscitation skills. At the end of each rotation, residents completed a post-test and survey identical to the pre-test. Interns also participated in a simulation scenario, and an NRP skills checklist was used to evaluate their performance. The effectiveness of the curriculum was assessed by measuring improvements in knowledge, simulation performance, and confidence in leading resuscitation.

Results: Paired t-tests were used to compare pre- and post-test scores and surveys to assess changes in knowledge and confidence. Interns who rotated twice had their NRP skills checklist scores compared between rotations to assess skill retention. Results showed a significant increase in theoretical knowledge (Pre- and Post-Rotation difference: 2.1; 95% CI: 1.33-2.86; P< 0.001) and confidence in leading neonatal resuscitation (P < 0.001) for each rotation. Interns also showed improved skill retention between rotations (Rotation 1 vs Rotation 2 difference: 3.7; 95% CI: 1.3-6.4; P=0.014).

Conclusion(s): A formal NRP curriculum incorporating direct observation, targeted didactics, and simulation significantly improves pediatric residents' theoretical knowledge, skill retention, and confidence in neonatal resuscitation. This curriculum enhances residents' preparedness for neonatal resuscitation, which may improve outcomes for neonates requiring resuscitation and support continued competence after residency.

Curriculum Design and Outcomes: Knowledge, Skills, and Confidence in Neonatal Resuscitation