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Who’s counting? Assessing the effects of a simulation-based training intervention on the accuracy of neonatal heart rate auscultation

Journal of Perinatology (2019) | Download Citation



To determine if simulation-based medical education could improve pediatric residents’ ability to accurately assess neonatal heart rate via auscultation.

Study design

Primary outcomes included heart rate accuracy and Neonatal Resuscitation Program (NRP) group accuracy, defined as whether a heart rate estimation fell in the appropriate NRP algorithm group. Pediatric residents completed a pre-assessment and then participated in a simulation training intervention on high-fidelity manikins. Residents completed a post-assessment 1 month later.


Heart rate estimates from 21 pediatric residents showed improved overall heart rate accuracy and NRP group accuracy from 53.6 to 78.7% (p < 0.0001) and 68.3 to 80% (p = 0.0002), respectively. Residents were more likely to overestimate low heart rates and underestimate high heart rates.


Heart rate simulation-based training significantly improved residents’ ability to assess heart rate on high-fidelity neonatal manikins. Providers participating in NRP may benefit by receiving heart rate skills assessment-focused training during an NRP provider course.

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This research was presented in part at the 2018 Pediatric Academic Society Meeting in Toronto, Canada and the 2018 Pediatric Hospital Medicine Meeting in Atlanta, GA.

Author contributions

NM—Study conception, design, data analysis, manuscript drafting and editing, approved final manuscript. NK—Study conception, design, simulation center liason, manuscript editing, approved final manuscript. SR—Study conception, design, manuscript editing, approved final manuscript. SD—Study design, significant data analysis, approved final manuscript. JB—Study conception, design, manuscript editing, approved final manuscript. VS—Study conception, design, manuscript editing, approved final manuscript.

Author information


  1. Department of Pediatrics, Staten Island University Hospital, Northwell Health, Staten Island, NY, USA

    • Nathan Money
    • , Natalya Kusheleva
    • , Susana Ruano
    • , Jonathan Blau
    •  & Vinisha Singhi
  2. Biostatistics Unit, Feinstein Institute for Medical Research, Northwell Health, New York, NY, USA

    • Seleshi Demissie
  3. Division of Neonatology, Department of Pediatrics, Staten Island University Hospital, Northwell Health, Staten Island, NY, USA

    • Jonathan Blau
    •  & Vinisha Singhi


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Conflict of interest

The authors declare that they have no conflict of interest.

Corresponding author

Correspondence to Nathan Money.

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