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      Simulation in neonatal care: towards a change in traditional training?

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          Abstract

          Simulation has traditionally been used in neonatal medicine for educational purposes which include training of novice learners, maintaining competency of health care providers, and training of multidisciplinary teams to handle crisis situations such as neonatal resuscitation. Current guidelines recommend the use of simulation as an education tool in neonatal practice. The place of simulation-based education has gradually expanded, including in limited resource settings, and is starting to show its impact on improving patient outcomes on a global basis. Over the past years, simulation has become a cornerstone in clinical settings with the goal of establishing high quality, safe, reliable systems. The aim of this review is to describe neonatal simulation training as an effective tool to improve quality of care and patient outcomes, and to encourage the use of simulation-based training in the neonatal intensive care unit (NICU) for not only education, but equally for team building, risk management and quality improvement.

          Conclusion: Simulation is a promising tool to improve patient safety, team performance, and ultimately patient outcomes, but scarcity of data on clinically relevant outcomes makes it difficult to estimate its real impact. The integration of simulation into the clinical reality with a goal of establishing high quality, safe, reliable, and robust systems to improve patient safety and patient outcomes in neonatology must be a priority.

          What is Known:

          • Simulation-based education has traditionally focused on procedural and technical skills.

          • Simulation-based training is effective in teaching non-technical skills such as communication, leadership, and teamwork, and is recommended in neonatal resuscitation .

          What is New:

          • There is emerging evidence for the impact of simulation-based training on patient outcomes in neonatal care, but data on clinically relevant outcomes are scarce.

          • Simulation is a promising tool for establishing high quality, safe, reliable, and robust systems to improve patient safety and patient outcomes.

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          Most cited references60

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          The future vision of simulation in health care

          D. M. Gaba (2004)
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            Promoting Excellence and Reflective Learning in Simulation (PEARLS): development and rationale for a blended approach to health care simulation debriefing.

            We describe an integrated conceptual framework for a blended approach to debriefing called PEARLS [Promoting Excellence And Reflective Learning in Simulation]. We provide a rationale for scripted debriefing and introduce a PEARLS debriefing tool designed to facilitate implementation of the new framework. The PEARLS framework integrates 3 common educational strategies used during debriefing, namely, (1) learner self-assessment, (2) facilitating focused discussion, and (3) providing information in the form of directive feedback and/or teaching. The PEARLS debriefing tool incorporates scripted language to guide the debriefing, depending on the strategy chosen. The PEARLS framework and debriefing script fill a need for many health care educators learning to facilitate debriefings in simulation-based education. The PEARLS offers a structured framework adaptable for debriefing simulations with a variety in goals, including clinical decision making, improving technical skills, teamwork training, and interprofessional collaboration.
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              Debriefing with good judgment: combining rigorous feedback with genuine inquiry.

              Drawing on theory and empirical findings from a 35-year research program in the behavioral sciences on how to improve professional effectiveness through reflective practice, we develop a model of "debriefing with good judgment." The model specifies a rigorous reflection process that helps trainees surface and resolve pressing clinical and behavioral dilemmas raised by the simulation. Based on the authors' own experience using this approach in approximately 2000 debriefings, it was found that the "debriefing with good judgment" approach often sparks self-reflection and behavior change in trainees.
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                Author and article information

                Contributors
                nadya.yousef@aphp.fr
                romain.moreau.abc@gmail.com
                lsoghier@childrensnational.org
                Journal
                Eur J Pediatr
                Eur J Pediatr
                European Journal of Pediatrics
                Springer Berlin Heidelberg (Berlin/Heidelberg )
                0340-6199
                1432-1076
                12 January 2022
                : 1-8
                Affiliations
                [1 ]GRID grid.50550.35, ISNI 0000 0001 2175 4109, Division of Pediatrics and Neonatal Critical Care, Dept of Perinatal Medicine, “A.Béclère” Medical Center, , Paris Saclay University Hospitals, APHP, ; Paris, France
                [2 ]GRID grid.253615.6, ISNI 0000 0004 1936 9510, Department of Pediatrics, , The George Washington University School of Medicine and Health Sciences, ; Washington, DC USA
                [3 ]GRID grid.239560.b, ISNI 0000 0004 0482 1586, Department of Neonatology, , Children’s National, ; Washington, DC USA
                Author notes

                Communicated by Daniele De Luca

                Author information
                http://orcid.org/0000-0002-8604-0788
                Article
                4373
                10.1007/s00431-022-04373-3
                8753020
                35020049
                4bdb830d-a845-48bb-be25-e50c8fbae392
                © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2022

                This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

                History
                : 16 November 2021
                : 30 December 2021
                : 2 January 2022
                Categories
                Review

                Pediatrics
                simulation, neonatal care, resuscitation, quality improvement,teamwork,education,newborn
                Pediatrics
                simulation, neonatal care, resuscitation, quality improvement, teamwork, education, newborn

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