1. Jnah, Amy J. DNP, APRN, NNP-BC
  2. Newberry, Desi M. DNP, APRN, NNP-BC
  3. Trembath, Andrea N. MD, MPH
  4. Robertson, Tracey DNP, APRN, NNP-BC
  5. Downing, April MSN, APRN, C-NPT, NNP-BC
  6. Greene, Miriam RRT-NPS
  7. Sewell, Kerry MSLS


Background: The Neonatal Resuscitation Program's (NRP's) Sixth Edition introduced simulation-based training (SBT) into neonatal life support training. SBT offers neonatal emergency response teams a safe, secure environment to rehearse coordinated neonatal resuscitations. Teamwork and communication training can reduce tension and anxiety during neonatal medical emergencies.


Purpose: To discuss the implications of variability in number and type of simulation scenario, number and type of learners who comprise a course, and their influence upon scope of practice, role confusion, and role ambiguity.


Methods: Relevant articles from MEDLINE, CINAHL, EMBASE, Google Scholar, the World Health Organization, the American Heart Association, and NRP were included in this integrative review of the literature.


Findings/Results: Purposeful synergy of optimal SBT course construct with teamwork and communication can resist discipline compartmentalization, role confusion, and role ambiguity. Five key themes were identified and coined the "5 Rights" of NRP SBT. These "5 Rights" can guide healthcare institutions with planning, implementation, and evaluation of NRP SBT courses.


Implications for Practice: NRP SBT can facilitate optimal team function and reduce errors when teams of learners and varied scenarios are woven into the course construct. The simulated environment must be realistic and fully equipped to encourage knowledge transfer and attainment of the NRP's key behavioral outcomes.


Implications for Research: Investigation of teamwork and communication training with NRP SBT, course construct, discipline compartmentalization, and behavioral and clinical outcomes is indicated. Investigation of outcomes of SBT using a team-teaching model, combining basic and advanced practice NRP instructors, is indicated.