Instructor-led Course Formats

NRP Learner Education

Two Recommended Provider Course Formats for Instructor-led Courses

At this time, the familiar Instructor-led NRP Provider Courses and RQI for NRP both require instructor-led events. The NRP 8^th edition offers two learning formats for Instructor-led courses.

Sequential Practice and Evaluation

This format works for all NRP learners and those who do not often use their delivery room resuscitation skills.

The instructor facilitates learning by providing a skill demonstration and then coaching the learner until the learner no longer requires assistance. Before moving on to the next skill, the learner incorporates the skill into a short Practice Scenario (provided at the end of lessons 2 through 7 in the Textbook of Neonatal Resuscitation, 8^th edition). When the learner can lead their team in the correct algorithm sequence and perform their role relevant skills without coaching, they are ready to move on to the next skill. Each evaluative scenario builds on the knowledge and skills from the previous lessons.
For example, a team of 3-4 learners reviews and practices the skills needed to prepare for a birth, does a rapid evaluation of the newborn, and performs initial steps of newborn care. New NRP learners may benefit from “walking through” a Practice Scenario before each learner is evaluated on their ability to lead their team through these steps of the NRP algorithm. After each learner successfully leads their team through those steps, the team moves on to reviewing, practicing, and using positive-pressure ventilation in a Practice Scenario before demonstrating their individual ability to integrate PPV into the scenario progression.
Each Practice Scenario builds on the knowledge and skills from previous lessons, giving the instructor an opportunity to observe each learner lead their team through a series of scenarios of increasing complexity. When the learner has completed all Practice Scenarios in their Essentials or Advanced course without significant corrections or assistance, they pass the second and final point of evaluation in the NRP Provider Course and may proceed to simulation and debriefing.

Comprehensive Skills Test Format

The second learning format is called the Comprehensive Skills Test format, or a more familiar term for this method is “testing out.” This format is for learners who resuscitate newborns frequently and are experts at resuscitation. The Comprehensive Skills Test format may be used for Essentials and Advanced learners.

When a learner indicates readiness to test out, the instructor asks the learner to lead their team through one or more scenarios of increasing complexity. The learner leads the team through preparing for the birth, and either performs each skill with correct technique, or if the skill is outside their scope of practice, they act as assistant during the procedure (such as intubation). The learner must direct all aspects of the scenario without prompting or coaching from the instructor or team members. This allows the instructor to evaluate the learner’s knowledge of the NRP algorithm sequence and their ability to perform resuscitation skills using correct technique.
If the learner makes critical errors or needs coaching, the learner should be directed into the hospital’s method of NRP remediation. This may entail attempting to test out again at some point or attending a course that uses the Sequential Practice and Evaluation format.

The Comprehensive Skills Test format is for providers who have excellent skills and resuscitate babies frequently. Learners may have more success testing out of Essentials skills than Advanced skills. You may choose to offer the option of testing out of Lessons 1 through 4 only. It is possible that your hospital team of nurses, pediatric providers, and respiratory care practitioners do not resuscitate babies frequently enough for your program to offer the test out option at all. Your hospital’s Neonatal Resuscitation Program is not required to offer the Comprehensive Skills Test format.

Testing out is not a one-person activity. Testing out necessitates team resuscitation followed by simulation and debriefing. The simulation and debriefing component of instructor-led Provider Courses is required of all learners and offers a valuable opportunity for experienced NRP learners to practice more challenging scenarios than offered by Practice Scenarios. When an expert team of resuscitators are ready for simulation and debriefing, the NRP instructor should assess their needs and determine which scenarios would be clinically relevant and beneficial for the team. Expert teams are challenged by innovative scenarios such as resuscitation in an elevator or parking lot or being surprised by the birth of a baby with an undiagnosed abdominal defect. Simulation should focus on teamwork and communication skills, but technical skills and creative problem-solving are equally important and should be part of the team’s discussion during debriefing. The simulation and debriefing course component is the team’s chance to stretch their capabilities and improve team performance.