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A common neonatal medical training curriculum

Authors

Roehr CC, Breindahl M, van den Hoogen A, Johnston L

User group

Parents, healthcare professionals, professional societies, education providers, health services, and regulators of the profession

Statement of standard

All doctors providing care to infants and their families receive training using a competency based curriculum and assessment framework.

Rationale

Neonatal outcomes have been shown to be associated with the level of training of medical and nursing staff, as well as adequate staffing, and it has clearly been shown that healthcare professional education and consistent evidence-based practice shortens patients’ hospitalisation. (1,2)

In 1988, the European Society of Paediatric Research (ESPR) Working Group on Neonatology recognised the immediate need to specify minimum training requirements for the accreditation of neonatologists throughout Europe. (3) To ensure that infants and families receive standard and evidence-based quality of care, the European Database of 30 member countries from the Union of European Medical Specialties (UEMS) has shown a very high degree of consensus on key skills and competencies necessary to practice neonatology. (3) Consequently, the European Society for Neonatology (ESN), now called European Board of Neonatology (EBN), has developed a Curriculum and Assessment Framework (3), which was approved and endorsed by the European Board of Paediatrics (EBP). The curriculum supports the harmonisation of national programmes for subspecialist training in neonatology throughout Europe, aiming to establish unified training in neonatology by clearly defining standards. (4)

Benefits

  • Improved communication skills between medical teams and families and other members of the multi-disciplinary NICU teams (5–7)
  • Reduced mortality and morbidity (2)
  • Decreased rates of cerebral palsy and retinopathy of prematurity (8)
  • Harmonised standards of education and training for doctors practising neonatal intensive care through a common European curriculum (consensus)
  • Consistency in quality of care delivery in neonatology (consensus)

 

Components of the standard

Component Grading of evidence Indicator of meeting the standard
For parents and family    
1. Parents contribute to the delivery of medical education programmes. B (Low quality) Training documentation
       
For healthcare professionals    
2. Neonatologists are qualified in their sub-specialty as evidenced by the following criteria: B (Moderate quality) Certificates of award, professional portfolio
  Registered trainees have completed a period of at least three years with a recognised mentor, who is responsible for assessing and recording the competence level of the trainee within the sub-specialty. Completion of education links the following theory and practice elements:    
 
  • Theory modules relating to the neonate and their family within neonatology at all levels of care provision (Level 1-3).
   
 
  • Management of resuscitation, cardiorespiratory intensive care, thermoregulation, neurology, haematology and blood product transfusion, metabolism and endocrine disorders, nutrition, feeding, gastro-intestinal and hepatic disease, immunity and infection, transport of the infant.
   
 
  • Clinical decision-making skills, ward organisation, advanced parent counseling and communication skills on congenital anomalies and genetic disorders, family-integrated care and care of the well newborn infant.
   
       
For neonatal unit    
3. Infrastructure for educational programmes is provided. (see TEG NICU design) B (Moderate quality) Audit report
       
For hospital    
  N/A    
       
For professional societies    
4. Standards of care, including competencies at the local level are developed and regularly updated, disseminated and promoted. (3) B (Moderate quality) Guideline
       
For education providers    
5. A (post) graduate programme focused on neonatal medicine, including the following domains is provided: neonatal physiology and pathophysiology, family-centred care, clinical practice, leadership and teamwork, professional development and research. (3) B (Moderate quality) Training documentation
       
6. Core elements of training in neonatal medicine are included in educational curriculum of physicians taking care of infants. (3) B (Moderate quality) Training documentation
       
For health service and regulators of the profession    
7. Common national training frameworks aligned with the relevant European Qualification Framework are available and regularly updated. B (High quality) Training documentation
       

Where to go

Further development Grading of evidence
For parents and family  
  • Parents are provided with the opportunity to review and revise neonatal medical curricula.
B (Very low quality)
For healthcare professionals  
  • Undertake continuous professional development (CPD) to remain up-to-date and sustain expertise (maintenance of competence). (9) (see TEG Education & training)
B (High quality)
  • Acquire new or expanded skills and abilities so that practice can evolve over time in response to practice needs and interests (advanced expertise). (9)
B (High quality)
  • Provide opportunities to maintain competence in procedural, communication, and other professional skills. (9)
B (High quality)
For neonatal unit  
N/A  
For hospital  
  • Support healthcare professionals to undertake continuous professional development (CPD).
B (High quality)
For professional societies  
  • Develop, disseminate and promote care competencies at regional, national, and international level. (9)
B (High quality)
For education providers  
  • Provide specialty national training programmes in line with agreed subspecialist neonatal training in Europe, as outlined by the ESPR/EBN assessment framework. (10)
B (High quality)
  • Offer access to professional development programmes which foster the development of personal skills and competencies in leadership, such as counselling and managerial, leadership, and teaching roles. (9)
B (High quality)
For health service and regulators of the profession  
  • International mutual recognition of specialty qualifications in neonatal medicine is facilitated.
B (Moderate quality)
   

Getting started

Initial steps
For parents and family
  • Parents are involved in the delivery of medical education programmes.
For healthcare professionals
  • Attend broader specialty training through a university administered neonatal online training and education programme. (11)
For neonatal unit
N/A
For hospital
  • Support healthcare professionals to participate in broader specialty training.
For education providers
  • Promote and offer access to professional development programmes.
  • Include neonatal care content in undergraduate curricula.
For health service
  • Provide opportunities for neonatal placements during clinical training.
  • Develop and implement common training frameworks aligned with the relevant European Qualifications Framework. (10)
 

Sources

  1. Lake E, Patrick T, Rogowski J, Horbar J, Staiger D, Cheung R, et al. The Three Es: How Neonatal Staff Doctors’ Education, Experience, and Environments Affect Infant Outcomes. JOGNN. 2010;(39):S97-98.
  2. Grandi C, González A, Meritano J, Grupo colaborativo Neocosur. [Patient volume, medical and nursing staffing and its relationship with risk-adjusted outcomes of VLBW infants in 15 Neocosur neonatal network NICUs]. Arch Argent Pediatr. 2010 Dec;108(6):499–510.
  3. Breindahl M, Blennow M, Fauchère J-C, Lluch MT, De Luca D, Marlow N, et al. The European database for subspecialist training in neonatology – transparency achieved. Neonatology. 2013;103(1):74–82.
  4. ESN database, training – knowledge (SEP 2011).pdf [Internet]. [cited 2018 May 15]. Available from: http://esn.espr.info/templates/espr/images/pdf/database/ESN%20database,%20training%20-%20knowledge%20(SEP%202011).pdf
  5. Lee M-C, Chen Y-C, Chen C-H, Lu FL, Hsiao C-C, Peng N-H. Comparison of the Educational Needs of Neonatologists and Neonatal Nurses Regarding Palliative Care in Taiwan. Am J Hosp Palliat Care. 2016 Apr;33(3):264–71.
  6. Hall SL, Cross J, Selix NW, Patterson C, Segre L, Chuffo-Siewert R, et al. Recommendations for enhancing psychosocial support of NICU parents through staff education and support. J Perinatol. 2015 Dec;35(Suppl 1):S29–36.
  7. Henner N, Boss RD. Neonatologist training in communication and palliative care. Semin Perinatol. 2017;41(2):106–10.
  8. Horbar JD, Plsek PE, Leahy K, NIC/Q 2000. NIC/Q 2000: establishing habits for improvement in neonatal intensive care units. Pediatrics. 2003 Apr;111(4 Pt 2):e397-410.
  9. Frank J, Snell L, Sherbino J, editors. CanMEDS 2015 Physician Competency Framework. Ottawa: Royal College of Physicians and Surgeons of Canada; 2015.
  10. ESPR European Society for Paediatric Research – Education [Internet]. [cited 2018 May 15]. Available from: http://www.espr.info/education/education
  11. NOTE [Internet]. [cited 2018 May 15]. Available from: https://moodle.neonataltraining.eu/

November 2018 / 1st edition / next revision: 2021

Recommended citation

EFCNI, Roehr CC, Breindahl M et al., European Standards of Care for Newborn Health: A common neonatal medical training curriculum. 2018.

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