P1.193: Enhancing NICU & Newborn Nursery Education: Leveraging Case-Based Flashcards for Resident Training

Background: Educational experiences during residency can be limited by time and clinical exposure in rotations. With recent changes in ACGME guidelines for pediatric residencies, the need for consistent education that is not reliant on time and exposure is warranted. Research shows that "retrieval-based" practice, where residents actively recall information, enhances both short- and long-term memory retention compared to passive learning. Flashcards have been shown to help improve learning amongst residents and can help achieve deeper levels of processing knowledge in a self-directed manner. Case-based learning (CBL) is a style that is shown to have more engagement, interaction, peer-to-peer education, and overall residents’ satisfaction. Therefore, to address these upcoming challenges, the pediatric residency program at NYU Langone Hospital-Long Island proactively integrated case-based flashcards (Figure 1) into the NICU and newborn nursery curriculum to enhance learning and improve educational experiences.

Methods: This is a single-center longitudinal study evaluating the educational experience of pediatric residents before and after introducing case-based flashcards in the NICU and newborn nursery. Pre- and post-intervention surveys were administered to assess comfort in recognizing, interpreting, and managing common clinical problems, as well as overall satisfaction with the educational experience. Scores from the General Pediatrics In-Training Examination (ITE), particularly in the "Fetal and Neonatal Care" domain, will be reviewed to assess long-term knowledge retention. Flashcards were designed in accordance with the content domain for “Fetal and Neonatal Care” on the ITE.

Results: Baseline data from the pre-intervention survey (N=23) compared to the post-intervention survey (N=5) in the NICU showed improvements in residents’ ability to recognize common problems, interpret findings, apply learned concepts to practice, and identify knowledge gaps (Figure 2a). Similarly, data from the newborn nursery (pre-survey N=21, post-survey N=3) demonstrated improvements across all measured categories (Figure 2b). Results from the 2021-2023 ITE for PGY 1-3 residents showed a 63.5% (national average of 63.7%) correct response rate in the "Fetal and Neonatal Care" domain, with a breakdown of 50% for PGY 1 and 70% for both PGY 2 and 3. Although not available yet, as the ITE takes place annually, we aim to increase the scores for each residency year by 10% by the end of the study period.

Conclusion: There is a continual need to enhance pediatric resident education, especially in areas with reduced clinical exposure like the NICU and newborn nursery. This study shows that case-based flashcards can improve residents' learning experiences and their ability to apply knowledge in clinical settings. Despite a decrease in exposure to these rotations, case-based flashcards provide an effective tool to strengthen residents’ educational development for neonatal knowledge. This is currently an ongoing project with ongoing data collection; promising results have been shown within three months of implementation.