Abstract
This article was migrated. The article was marked as recommended. Objective: To develop a compact, simulation-based orientation session aimed at improving confidence and teamwork amongst new trainees. Methods: Two cohorts of five fellows participated in the one-day boot camp. Confidence in team leading and neonatal procedures was assessed using a pre and post survey administered on the day of boot camp as well as a delayed post-test after 6 months. Teamwork and communication were assessed using the TEAM scale. Results: We found that fellows confidence was significantly improved in 5 out of 6 categories (team leader in code (p < 0.001), team leader in delivery room (p < 0.001), decision making (p < 0.001), intubation (p < 0.001), chest tube placement (p < 0.001) and umbilical catheter placement (p = 0.09)). There was an overall improvement in teamwork, team leadership and communication throughout the day (p < 0.001). There was no significant change in self-reported confidence scores in all categories 6 months following boot camp. Conclusions: We demonstrated a significant improvement in confidence in first year neonatal-perinatal medicine fellows following a one-day simulation-based boot camp. The format for this boot camp could be emulated in institutions across the country to improve the confidence and skills of incoming fellows.
Highlights
The first month of fellowship training can be an overwhelming transition
Unfamiliarity with a new medical institution, uncertainty regarding complex medical diagnoses and inexperience with procedural and communication skills can contribute to the challenge. (Nishisakiet al., 2009; Younget al., 2011; Cohenet al., 2013; Wenet al., 2015)In the neonatal intensive care unit (NICU), incoming fellows have had increasingly limited experiences due to work hour restrictions and may be further limited by the level of acuity at their previous institution
Following the implementation of boot camp, we saw a significant improvement in the mean self-reported confidence scores for fellows in making medical decisions, acting as a team leader during a code and neonatal resuscitation, chest tube insertion and intubation
Summary
The first month of fellowship training can be an overwhelming transition. Unfamiliarity with a new medical institution, uncertainty regarding complex medical diagnoses and inexperience with procedural and communication skills can contribute to the challenge. (Nishisakiet al., 2009; Younget al., 2011; Cohenet al., 2013; Wenet al., 2015)In the neonatal intensive care unit (NICU), incoming fellows have had increasingly limited experiences due to work hour restrictions and may be further limited by the level of acuity at their previous institution. An orientation experience to onboard fellows to the institution and the position may help smooth this transition and reduce their stress. Neonatal fellowship programs do not have a standardized process for orientation leaving individual fellowships to develop an onboarding process. To help fill this need, an orientation curriculum, based on specific institutional needs assessments should be developed. Boot camps utilize various modes of teaching, including: simulation-based exercises, focused procedural skills (task training) sessions and resuscitation leadership opportunities in an arena similar to the patient care environment. Boot camps utilize various modes of teaching, including: simulation-based exercises, focused procedural skills (task training) sessions and resuscitation leadership opportunities in an arena similar to the patient care environment. (Blackmoreet al., 2014)
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