Teaching Newborn Diagnosis and Management Through Simulation Stations

Background:  Neonates are a vulnerable population and can present with potential disorders that require immediate attention and intervention. In addition, families are also vulnerable and lack knowledge/experience in managing their newborn infant. Learning newborn care is essential for neonatal nurse practitioners (NP), but it is also a process that pediatric and family NPs must  master. Many NP students have not cared for neonates in nursing practice and have not had experience in diagnosis and management of problems frequently seen in the newborn period. Providing newborn clinical experiences does not insure that students will have  opportunities to care for infants  with common newborn problems, like heart murmurs, physiologic jaundice, hypoglycemia, respiratory distress and suspected sepsis. NP students must also be prepared to provide support for feeding and dsicharge instructions for new families.  Short simulation exercises set up with objective measures allow student practice and encourage familiarity in diagnosing and managing these common infant problems. The SMARTER (Simulation Module for Assessment of Resident Targeted Responses) tool is used to create the scenarios which students rotate through during a newborn simulation day. 

 Process: Simulation experiences are short low to mid-level fidelity modules in which students work as the providers of care for a specific newborn problem. The simulation “stations” consist of a manikin, standardized parent and a faculty member who guides the scenario and the debriefing.  There are various methods of presenting the infant/family scenarios, based on the underlying neonatal problem. Students are encouraged to review American Academy of Pediatrics clinical practice guidelines in relation to solving the problems. Students are expected to be able to interact with a family member while caring for the infant so standardized parents participate in this role.

 Evaluation: Students are tested within a midterm and final exam on concepts learned in class (didactic) and then this information is reinforced through simulation experiences. Students complete evaluations of the experience on “Ipad” templates for review by simulation and pediatric faculty.  Debriefing with students, SPs and faculty helps to identify missed learning opportunities.