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Hosp Pediatr. 2019 Aug 1. pii: hpeds.2018-0219. doi: 10.1542/hpeds.2018-0219. [Epub ahead of print]

Retention of Basic Neonatal Resuscitation Skills and Bag-Mask Ventilation in Pediatric Residents Using Just-in-Place Simulation of Varying Frequency and Intensity: A Pilot Randomized Controlled Study.

Author information

Perinatal Institute and
Global Child Health, and.
Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio.
Divisions of Biostatistics and Epidemiology.
Center for Simulation and Research, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; and.
Emergency Medicine, and.



Pediatric residents quickly lose neonatal resuscitation (NR) skills after initial training. Helping Babies Breathe is a skills-based curriculum emphasizing basic NR skills needed within the "Golden Minute" after birth. With this pilot study, we evaluated the feasibility of implementing a Golden Minute review and the impact on overall performance and bag-mask ventilation (BMV) skills in pediatric interns during and/or after their NICU rotation, with varying frequency and/or intensity of "just-in-place" simulation.


During their NICU rotation, interns at 1 delivery hospital received the Golden Minute module and hands-on simulation practice. All enrolled interns were randomly assigned to weekly retraining or no retraining for their NICU month and every 1- or 3-month retraining post-NICU for the remainder of their intern year, based on a factorial design. The primary measure was the score on a 21-item evaluation tool administered at the end of intern year, which was compared to the scores received by interns at another hospital (controls).


Twenty-eight interns were enrolled in the intervention. For the primary outcome, at the end of intern year, the 1- and 3-month groups had higher scores (18.8 vs 18.6 vs 14.4; P < .01) and shorter time to effective BMV (10.6 vs 20.4 vs 52.8 seconds; P < .05 for both comparisons) than those of controls. However, the 1- and 3-month groups had no difference in score or time to BMV.


This pilot study revealed improvement in simulated performance of basic NR skills in interns receiving increased practice intensity and/or frequency than those who received the current standard of NR training.


Conflict of interest statement

POTENTIAL CONFLICT OF INTEREST: Dr Kamath-Rayne was the associate editor of Helping Babies Breathe, Second Edition, and serves on the American Academy of Pediatrics Helping Babies Survive planning group. The American Academy of Pediatrics did not contribute to the design or analysis of this study; the other authors have indicated they have no potential conflicts of interest to disclose.

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