Exploring neonatal resuscitation competencies in residents and recently graduated pediatricians

Abstract

Introduction: The practice of neonatal resuscitation involves superior technical skills, an ability to lead an interdisciplinary team as well as make clinical decisions based on complex dynamic transitional physiology within a narrow timeline. These skills are a mandatory component of pediatric residency training and have been assessed using standardized assessment tools such as certifying board exams, procedure checklists, and in training exams. Recent literature has raised concerns about trainees’ competency in the technical skills for neonatal resuscitation. This project sought to explore trainees’ perceptions of competency for neonatal resuscitation, as well as potential barriers that challenge this process.

Methods: This project employed an interpretive design qualitative methodology, using an a priori educational theory incorporating the principles of social cognitive theory, deliberate practice, distributive practice, and ‘choke phenomenon’. Semi structured focus groups of residents and pediatricians were used for data collection. Interpretive analysis in the style of Crabtree and Miller was employed. Validity criteria as described by Lincoln and Guba were applied. Institutional ethics board approval was obtained.

Results: The participants identified four attributes for competency in neonatal resuscitation required to ensure successful transition towards readiness for independent practice: (a) medical expertise, (b) leadership, (c) transferability, and (d) self-efficacy. The enablers and barriers towards acquisition of these four aspects during residency training and transition to practice were identified and explored.

Conclusions: Through the self-reported experiences of trainees and practitioners and informed by educational theory, this study describes a “across rocky seas” graduated conceptual model of a sailing ship for competency acquisition in neonatal resuscitation. An understanding and application of this model may thus inform the development of new competency-based curricula.