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Paediatr Child Health. 2009 Jan;14(1):19-23.

High-fidelity simulation in neonatal resuscitation.

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Department of Paediatrics, St Michael's Hospital, University of Toronto, Toronto, Ontario.



There are currently few studies describing the use of high-fidelity (hi-fi) simulation in teaching neonatal resuscitation. Traditionally, residents are certified in the neonatal resuscitation program (NRP) after successful completion of a multiple-choice written examination and demonstration of skills during a hands-on 'mega-code'. In the present study, the use of a hi-fi simulation mannequin was compared with a standard plastic mannequin when teaching the megacode portion of the NRP.


In the present pilot study, 15 first-year residents were randomly assigned to demonstrate neonatal resuscitation knowledge, with either the hi-fi mannequin (SimBaby, Laerdal Medical Corporation, USA) or a traditional plastic mannequin (ALS Baby, Laerdal Medical Corporation, USA). A written evaluation was conducted before and after the intervention. Each pair of residents experienced the two scenarios. Video performance was then assessed and compared.


Residents randomly assigned to the hi-fi mannequin rated the experience higher (31+/-3.3 versus 27+/-3.5; P=0.026), and required less redirection from instructors during the megacode (scenario 1: 4.5+/-1.7 versus 15+/-6.9; P=0.015 and scenario 2: 1.8+/-1.3 versus 9.3+/-2.5; P=0.0009) than those who were randomly assigned to the plastic mannequin. Residents randomly assigned to the hi-fi mannequin did not have improved written scores or improved intubation times.


The present pilot study demonstrated that a hi-fi mannequin can be used as part of an educational program, such as the NRP. The use of this technology in neonatal resuscitation training is well-received by learners and may provide a more realistic model for training. Further work is required to clarify its role in task performance and team training.


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