Just-In-Time Neonatal Endotracheal Intubation Simulation Training: A Randomized Controlled Trial

Area of Science:

• Medical Education
• Pediatric Critical Care
• Simulation-Based Learning

Background:

• Neonatal endotracheal intubation (ETI) is a critical skill for pediatric residents.
• Current training methods, such as video-based learning, may have limitations in skill acquisition.
• Simulation-based just-in-time training (JITT) offers a potentially more effective approach.

Purpose of the Study:

• To compare the efficacy of simulation-based just-in-time training (JITT) versus traditional video training for neonatal ETI.
• To evaluate the impact of JITT on ETI success rates, number of attempts, duration, and complications.

Main Methods:

• A Canadian multicenter randomized trial involving junior residents performing neonatal ETI.
• Comparison of overall and first-attempt ETI success rates between JITT and video training groups.
• Assessment of secondary outcomes including number/duration of attempts, complications, and resident confidence.

Main Results:

• Overall ETI success rates were similar between JITT and video training (67% vs 70%).
• Simulation-based JITT significantly improved first-attempt success rates (54% vs 41%).
• JITT reduced the mean duration and tendency for the number of ETI attempts, but increased mucosal trauma events.

Conclusions:

• Simulation-based JITT did not improve overall neonatal ETI success but enhanced first-attempt success.
• JITT effectively decreased the number and duration of ETI attempts.
• Simulation-based JITT is a valuable adjunct for resident training in neonatal endotracheal intubation.