Abstract
BACKGROUND: For paediatrics residents, much of newborn care is learned during Neonatal Intensive Care Unit (NICU) rotations. However, the NICU is a high-stress and specialized learning environment. Today’s residents often have less NICU exposure during their training than in the past, leading to concerns from trainees that they are inadequately prepared for neonatal care and resuscitation upon graduation. OBJECTIVES: We aimed to develop, implement and evaluate a paediatric residency NICU curriculum aimed to augment and improve learning on rotation. DESIGN/METHODS: We utilized Kern’s Six Step Approach for Curriculum Development. Step 1: We identified that our paediatric residents consistently expressed dissatisfaction with the quality and quantity of learning opportunities on their NICU rotations. Step 2: A collaborative working group of residents, paediatricians, and neonatologists identified learning needs. Step 3: Needs were mapped to specific general paediatrics educational objectives within the Royal College Competency Based Medical Education (CBME) curriculum. Step 4: Suitable learning strategies were selected including simulation, procedural skill training, embedded time with the neonatal resuscitation team, and lunch and learn seminars. Steps 5 and 6: The curriculum was piloted during the 2021-2022 academic year and resident reactions evaluated. RESULTS: The detailed curriculum is shown in Table 1. At the start of each NICU rotation, all paediatrics residents on rotation attended a half-day simulation based “boot-camp” consisting of a didactic Neonatal Resuscitation Program (NRP) refresher course, relevant procedural skills stations (intubation, UVC placement, needle thoracocentesis), and simulated neonatal resuscitation scenarios. Junior residents were scheduled for protected time to attend deliveries with a dedicated multidisciplinary resuscitation team to ensure familiarity and begin to solidify skills. Learning was further augmented by weekly, resident-led lunch and learn sessions on topics mapped to level of training. To evaluate this curriculum, resident satisfaction was assessed using surveys post bootcamp and at the end of their rotation. Overall, the curriculum was well received. Bootcamp was the highest rated element; 96% of residents agreed or strongly agreed that the session was useful for their education (Figure 1). Post curriculum implementation, there was significant improvement in resident NICU rotation feedback; residents expressed that the NICU learning environment and resident experience has improved. CONCLUSION: We successfully implemented a NICU curriculum for paediatrics residents, with high satisfaction ratings and improved overall rotation feedback. This program shows promise in addressing a long standing educational gap. More research is needed to investigate whether it leads to improved competency in practice.