Telesimulation for Neonatal Resuscitation Training

Available online 20 September 2023, 151827

Author links open overlay panel, Abstract

Telesimulation uses telecommunication and simulation to educate and assess remote learners, obviating the need for instructors or learners to travel off site. Telesimulation increases access to and convenience of simulation-based education for sites that do not have formal simulation centers, including rural/remote areas. Telesimulation is feasible, improves knowledge and skills, and is favorably received by learners and instructors. In general, telesimulation has been shown to be effective for neonatal resuscitation training, even in low- and middle-income countries. Post telesimulation debriefing, termed teledebriefing requires many of the skills of in-person debriefing, and teledebriefing can optimize the learning by exposing learners to content experts in geographically distant sites or from specialties not available locally. When implementing telesimulation for neonatal resuscitation training, key considerations include program design, telecommunication platform, pre-telesimulation preparation, and teledebriefing. Additional research is needed to identify whether lessons learned during telesimulation translate to clinical practice and impact patient outcomes.

Section snippetsBackground

Telesimulation is the process by which telecommunication and simulation resources are utilized to provide education, training, and/or assessment to learners at an off-site location, remote from the instructor.1 Telesimulation helps learners develop cognitive, kinesthetic, and psychomotor skills by providing hands-on training that is facilitated by task trainer and instructor feedback. Like in-person simulation, telesimulation utilizes the basic tenets of adult learning theory through

Benefits of telesimulation

Telesimulation increases access to simulation-based education and training for sites that do not have formal simulation centers,8 especially those in rural or remote areas. Through telesimulation, experienced educators can reach a larger group of learners and keep off-site learners in their clinical environments. The advantage of such in situ simulation, in which team training occurs in the actual working environment,11,12 is that effective learning is tightly linked to the context of the

Telesimulation to train healthcare personnel

Multiple studies show that telesimulation to teach adult emergency and critical care skills is feasible, improves knowledge and skills, and is favorably received by learners.16, 17, 18, 19 Telesimulation has also been shown to improve learners’ knowledge of ventilator management in patients with hypoxemic respiratory failure due to COVID-19.20

Telesimulation for pediatric resuscitation training has also been shown to improve performance and is equally well received when compared to in-person

Telesimulation for neonatal resuscitation training

Telesimulation has been used for neonatal resuscitation training across a diverse group of learners and for a variety of clinical resuscitation scenarios, including extreme prematurity, placental abruption, prolonged shoulder dystocia, and congenital diaphragmatic hernia.18 With enhanced connection to experts in both neonatal resuscitation and simulation-based education, telesimulation creates additional opportunities for staff in rural or critical access hospitals to receive continued

Implementing a telesimulation program

Establishing a telesimulation curriculum and program requires preparation and resources. 7,8,10,18,22 Of primary importance is assembling the team that will plan and perform the telesimulation. At a minimum, this includes the in-person facilitator/instructor and the remote facilitator/instructor. The remote facilitator is typically the simulation and content expert who connects from an off-site location. In addition, an expert in information technology or communications, a simulation

Performing telesimulations

For telesimulation, the facilitator(s) will complete pre-telesimulation preparations, perform the telesimulation, and conduct a post-telesimulation debriefing.

Special focus on teledebriefing

Teledebriefing is the use of videoconferencing capabilities to debrief learners at a remote location.33 Despite being the most important element of simulation education, many instructors are not well-trained in debriefing techniques.34,35 Connecting educators from geographically distant areas, or from specialties not available locally, exposes learners to content experts who can provide high-quality debriefing, optimizing the educational benefits of telesimulation.

The reported effectiveness of

Evidence on the effectiveness of telesimulation

Studies show that telesimulation may allow for similar learning outcomes when compared to in-person simulation.10,41,42 A prospective, randomized crossover study comparing the effectiveness of telesimulation to in-person simulation for medical students’ management of critically ill patients demonstrated no significant differences in post-training knowledge between the two groups.41 Telesimulation has also been shown to be effective for procedural skills training.42,43 Canada pediatricians used

Conclusion

Telesimulation and teledebriefing are innovative solutions to the logistical challenges of simulation and the lack of widely available expertise in simulation facilitation and debriefing, especially in highly specialized fields. There is growing evidence of the efficacy of telesimulation for procedural and team training and for improving patient outcomes. Although learners have demonstrated an openness to this approach, basic technical knowledge, advanced preparation, and on-site support are

Funding support

Dr. Umoren is partially supported by AHRQ R18 HS027259 and NICHD R21HD107984

Declaration of Competing Interest

The authors report no potential conflicts of interest. (Authors please confirm complete and correct)

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