Proficiency and retention of neonatal resuscitation skills by pediatric residents.

Abstract

The basic knowledge and skill base to resuscitate a newborn infant is taught in the Neonatal Resuscitation Program (NRP). We hypothesize that caregivers will perform below current acceptable standards before the recertification period of two years. This is a prospective descriptive study evaluating performance of pediatric residents' NRP knowledge and skills over time. NRP scores are used as baseline data. Follow-up is performed before the resident's first NICU rotation. Differences in the mean scores are analyzed for degree of retention. Subset score analysis is also performed. Eighty-eight subjects completed both evaluations. Knowledge scores maintained close to passing throughout the academic year. Subset evaluation revealed significant deficits within the intubation lesson. Alarming deficits were seen in skills evaluation starting at initial NRP certification with 39.1% residents having failing scores. Mean scores were below passing for every group on follow-up testing. Subgroup analysis of skills revealed deficits in the initial phases of resuscitation (lessons 1-3). Deterioration of skills is seen shortly after training. It appears that knowledge is generally better retained. Discrepancies between areas of knowledge and skill deterioration indicate that proficiency in one does not necessarily indicate proficiency of the other.