Educational Perspectives: Toward More Effective Neonatal Resuscitation: Assessing and Improving Clinical Skills

Newborn deaths following birth asphyxia remain a significant global problem, and effective resuscitation by well-trained professionals may reduce mortality and morbidity. Clinicians are often responsible for teaching newborn resuscitation to trainees. Multiple educational methods are used to teach these skills, but data supporting their efficacy are limited. Mask ventilation and chest compressions are considered the basics of resuscitation. These technical motor skills are critically important but difficult to teach and often not objectively assessed. Teaching more advanced skills such as neonatal intubation is challenging, because teaching opportunities and working hours of learners have declined. Videolaryngoscopy appears to be an effective teaching tool that allows instruction during clinical practice. There is also emerging recognition that effective resuscitation requires more than individual clinical skills. The importance of teamwork and leadership is now recognized, and teamwork training should be incorporated because it improves these nontechnical skills. Simulation training has become increasingly popular as a method of teaching both technical and nontechnical skills. However, there are unanswered questions about the validity, fidelity, and content of simulation. Formal resuscitation programs usually incorporate a mixture of teaching modalities and appear to reduce neonatal mortality and morbidity in low- and middle-income countries. Emerging teaching techniques such as tele-education, video debriefing, and high-frequency training warrant further investigation.