In addition to knowing the neonatal resuscitation algorithm and passing the exam, learners should feel confident that they can treat high-risk neonates. This includes being able to identify at-risk deliveries before a situation arises as well as being keenly aware of the patient environment.

An instructor-led event held in situ, or in the real clinical environment, can ensure that learners remain vigilant in inspecting the room and managing the patient. Concerns that can be addressed with in situ simulation training include:

• Learning where necessary equipment is stored.
• Reinforcing strong team behaviors.
• Managing the limited space surrounding the small patient.
• Identifying potential flaws in the system.

Using in situ simulation to enhance a learner's hands-on training can help shape stronger connections between a provider and the NRP course material.

When a healthcare professional renews their NRP status at an off-site location, the information is incredibly useful but also generalized. Learners don’t receive information about hospital-specific protocols, which are necessary in order to perform optimally within their own organization.⁴

Special attention won't be given to how a learner's discipline might equate to adopting a specific role or responsibility in a real neonatal emergency. And, because of this, often learners are required to attend a separate training with their respective unit to discuss internal policies and procedures.

Though not all organizations have the resources to provide their own in-house NRP training courses, it’s worth considering how beneficial it can be to providers and their patients. The ability to refresh NRP skills and guidelines alongside any additional expectations by an employer can streamline the learning process and shape safe patient care practices.

For the instructor-led portion of the NRP course, the use of simulation drives home the clinical concepts and skills that providers need to save a newborn life. However, research shows that these skills begin to deteriorate shortly after the training.⁵

Continued practice using simulation can ensure that healthcare providers maintain their strong NRP skills over time and, certainly, in between recertifications. Suggestions to keep the learning interesting include:

• Varying the patient scenarios given to providers, rather than repeating the same one.
• Introducing premature patient cases and using a premature infant patient simulator.
• Changing the simulation setting.

By providing regular and diverse simulation training experiences, you can ensure that learners remain confident in their ability to address any neonatal patient emergency.