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UW Pediatrics

NEST Program

Neonatal Education and Simulation-Based Training Program

Mission

To improve neonatal outcomes through technology-enhanced training and simulation research.

Vision

To provide global leadership in neonatal education, simulation-based training, and scholarship.

Specific Aims

  • Improve neonatal outcomes through individual and interprofessional education
  • Leverage emerging technologies for simulation-based training and research  
  • Define optimal processes for neonatal resuscitation 
  • Investigate methods to enhance the acquisition and retention of technical and behavioral skills
  • Promote educational scholarship in the next generation of neonatal care providers

NEST Initiatives

  • Regional boot camp for neonatal-perinatal fellows 
  • National neonatology fellows’ curriculum
  • Teleneonatology/Telesimulation
  • Neonatal resuscitation/procedural skills training 
  • Team training to optimize neonatal care  
  • Virtual simulation training with augmented and mixed reality 
  • Disaster simulations
  • Outreach education to support regional neonatal care

NEST Program Faculty

Rachel A Umoren, MB, ChB, MS

Associate Professor Associate Division Head, Research Medical Director, Inpatient Telehealth, Seattle Children’s Hospital Research Director, NEST Program Adjunct Associate Professor, Global Health & Healthcare Simulation Science

Megan Mariner Gray, MD

Associate Professor Program Director, Neonatal‐Perinatal Medicine Fellowship Training Program Associate Division Head of Education Co-Director, NEST Program

Thomas P. Strandjord, MD

Emeritus Clinical Professor

Taylor L Sawyer, DO, MEd, MBA

Division Head and William Alan Hodson Endowed Chair of Neonatology Professor

Zeenia C Billimoria, MD

Associate Professor Medical Director, Neonatal Transport and Extracorporeal Life Support Programs, Seattle Children’s Hospital Medical Director, NICU, Seattle Children’s Hospital Associate Medical Director, Neonatal Transport Program, Seattle Children’s Hospital Co‐lead, Seattle Children’s NICU Quality Improvement Microsystem

Sarah J Handley, MD

Clinical Associate Professor Associate Medical Director, NICU at Seattle Children's Co-Lead Bronchopulmonary Dysplasia team at Seattle Children’s Hospital Physician Liaison, Advanced Practice Providers Program at Seattle Children’s Hospital

Christine Cooper, DNP, ARNP, NNP-BC, MBA

Associate Director of Clinical Integration

 

 

 

Funding

  • Agency for Healthcare Research & Quality (2019-2023)
  • Simio Academic Software Institution Grant (2018-2022)
  • National Institute of Health (2017-2020)
  • Bill & Melinda Gates Foundation (2017-2020)
  • UW Neonatal Bioresearch Fund (2014-2020)
  • Microsoft MR Academic Seeding Program (2018)
  • UW Center for Leadership and Innovation in Medical Education (2017-2019)
  • UW Patient Safety Innovations Program (2017-2018)
  • National Science Foundation I-Corps Grant (2017)
  • Seattle Children’s Academic Enrichment Fund (2016-2019)
  • University of Washington CoMotion Innovation Fund (2016-2018)
  • Coulter Foundation (2015-2019)

Affiliations

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Follow the NEST program on Twitter @NESTSIM1

For more information on the NEST Program please send us an email: nestprog@uw.edu

Images of NEST training and care in action.

Peer-reviewed publications 2019-2020

  1. Brady J, Kovatis K, O’dea CL, Gray MM, Ades A. A Qualitative Analysis: What do neonatal-perinatal fellows identify as critical for achieving competency in tracheal intubation? Neonatology. 2019 Mar 19;116(1):10-16. PMID: 30889585.
  2. Chabra S, Sawyer T, Strand M. The “Meconium Aspirator”: Still a Useful Tool during Newborn Resuscitation. American journal of perinatology. 2019 Nov;36(13):1420-2.
  3. Enlow E, Gray MM, Wallace-Keeshen S, D'Agostino JA, Abbasi S, Lorch SA. Health literacy of parents of very preterm infants at NICU admission and discharge: a prospective cohort study. J Perinatol. 2019 Feb 15. PMID: 30770882. 4. Foglia E, Ades A, Sawyer T, Glass K, Singh N, Jung P, Quek BH, Johnston L, Barry J, Zenge J, Moussa A, Kim J, DeMeo S, Napolitano N, Nadkarni V, Nishisaki A, for the NEAR4NEOS Investigators. Neonatal intubation practice and outcomes: An international registry study. Pediatrics. 2019 Jan;143(1). pii: e20180902. PMID: 30538147
  4. Foglia E, Ades A, Sawyer T, Glass K, Singh N, Jung P, Quek BH, Johnston L, Barry J, Zenge J, Moussa A, Kim J, DeMeo S, Napolitano N, Nadkarni V, Nishisaki A, for the NEAR4NEOS Investigators. Neonatal intubation practice and outcomes: An international registry study. Pediatrics. 2019 Jan;143(1). pii: e20180902. PMID: 30538147
  5. Foglia E, Jensen E, Wyckoff M, Sawyer T, Topjian A, Ratcliffe S. Survival after delivery room cardiopulmonary resuscitation: a national registry study. Resuscitation. 2020 Jul;152:177-183. PMID: 31982507.
  6. French H, Arias-Shah AM, Gisondo C, Gray MM. The Flipped Classroom in Graduate Medical Education. NeoReviews. 2020 March; 21 (3): e150-156. PMID: 32123119
  7. Gray MM, Dadiz R, Izatt S, Gillam-Krakauer M, Carbajal M, Bonachea E, Falck A, Johnston L, Karpen H, Vasquez M, Chess P, French H. Value, Strengths, and Challenges of e-Learning Modules Paired with the Flipped Classroom for Graduate Medical Education: A Survey from the National Neonatology Curriculum. American Journal of Perinatology. Epub ahead of print 2020 April. PMID: 32276279
  8. Gray MM, Erika E, Ehret D, Brei B, Greenberg L, Umoren R, Ringer S, Horbar J. Opportunities for Resuscitation of Very and Extremely Low Birth Weight Infants During Fellowship. Pediatrics. Jun 2020, e20193641; 2019-3641.
  9. Gray MM, Thomas AA, Burns B, Jones N, Umoren R. Evacuation of Vulnerable and Critical Patients (EVAC): Multimodal simulation for nurse-led patient evacuation. Simulation in Healthcare. 2020 Dec 1;15(6):382-7.
  10. Gray MM, Thomas A, Burns B, Umoren R. Identifying Crucial Equipment and Skills Needed to Evacuate Critically Ill Infants During Disasters: Using Nursing Expertise to Guide Training Targets. Prehospital and Disaster Medicine. 2019 Aug; 34(4):370-375. PMID: 31239004.
  11. Hippe DS, Umoren RA, McGee A, Bucher SL, Bresnahan BW. A targeted systematic review of cost analyses for implementation of simulation-based education in healthcare. SAGE Open Medicine. 2020 Mar;8:2050312120913451.
  12. Izatt S, Gray M, Dadiz R, French H. Development and implementation of a national neonatology flipped classroom curriculum. Journal of Graduate Medical Education. 2019 June;11(3):335-336. PMID: 31210868.
  13. Keilman AE, Umoren R, Lo M, Roberts J, Yoshida H, Hartford E, Patrao F, Burns B, Fenstermacher S, Masse E, Reid J. Virtual protective equipment: Paediatric resuscitation in the COVID-19 era. BMJ Simulation and Technology Enhanced Learning. 2020 May 17:bmjstel-2020.
  14. Kukora S, Batell B, Umoren R, Gray MM, Ravi N, Thompson C, Zikmund-Fisher B. Hilariously Bad News: Medical Improv as a Novel Approach to Teach Communication Skills for Bad News Disclosure. Academic Pediatrics. 2020 May 7; S1876-2859. PMID: 32389759.
  15. Kumar D, Vachharajani AJ, Wertheimer F, Vergales B, Glass K, Dannaway D, Winter L, Delaney H, Ganster A, Arnold J, Urban A, Johnston L, Bruno C, Gray MM, Sawyer T, for the Organization of Neonatal Training Program Directors Task Force on Simulation. Boot camps in neonatal-perinatal medicine fellowship programs: a national survey. Journal of neonatal-perinatal medicine. 2019 Jan 1;12(2):231-7.
  16. Litke-Wager C, Delaney H, Mu T, Sawyer T. Impact of task-oriented role assignment on neonatal resuscitation performance: a simulation-based randomized controlled trial. American journal of perinatology. 2020 Jan 3.
  17. Ozawa Y, Ades A, Foglia E, DeMeo S, Barry J, Sawyer T, Singh N, Glass K, Jung P, Huey Quek B, Johnston L, Kim J, Napolitano N, Shults J, Nadkarni V, Nishisaki A, for the National Emergency Airway Registry for Neonates (NEAR4NEOS) Investigators. Premedication with paralysis during neonatal intubation is associated with fewer adverse events. J Perinatol. 39 (6):848-856, 2019.
  18. Roussin C, Sawyer T, Weinstock P. Assessing competency using simulation: the SimZones approach. BMJ Simul Technol Enhanc Learn. Published Online First: 20 September 2019. doi: 10.1136/bmjstel-2019-000480.
  19. Sawyer T, Burke C, McMullan M , Yalon L, Valdivia H, Chan T, Roberts J. Impacts of a pediatric extracorporeal cardiopulmonary resuscitation (ECPR) simulation training program. Academic pediatrics. 2019 Jul 1;19(5):566-71.
  20. Sawyer T, Foglia EE. Resuscitation quality metrics for the newly born. American journal of perinatology. 2020 Apr;37(05):553-6. 
  21. Sawyer T, Foglia E, Ades A, Moussa A, Napolitano N, Glass K, Johnston L, Jung P, Singh N, Quek BH, Barry J, Zenge J, DeMeo SD, Kim J, Nadkarni V, Nishisaki A, for the National Emergency Airway Registry for Neonates (NEAR4NEOS) investigators. Incidence, impact, and indicators of difficult intubations in the NICU. Arch Dis Child Fetal Neonatal Ed. 2019 Feb 22.
  22. Sawyer T, Motz P, Shooley N, Umoren R. Positive pressure ventilation coaching during neonatal bag-mask ventilation: A simulation-based pilot study. Journal of neonatal-perinatal medicine. 2019 Jan 1;12(3):243-8.
  23. Sawyer T, Rovera E J. Publication Activity and Impact of the International Pediatric Simulation Society Cureus Channel: 2014 to 2018. Cureus. 2019;11(2): e4067. DOI 10.7759/cureus.4067.
  24. Sawyer T, Johnson K. Neonatal intubation: past, present, and future. NeoReviews. 2020. May; 21(5): e335-e341. PMID: 32358146.
  25. Sawyer T. Educational strategies to improve outcomes from neonatal resuscitation. NeoReviews. 2020. July. 21(7):e431-e441. PMID: 32611561.
  26. Sawyer T, Stavroudis TA, Ades A, Dadiz R, Dammann CEL, Halamek LP, Moussa A, Soghier L, Gupta A, Aliaga S, Umoren R, French H. Simulation in neonatal-perinatal medicine fellowship programs. American journal of perinatology. 2020 Oct;37(12):1258-63.
  27. Shieh C, Khan I, Umoren R. Engagement design in studies on pregnancy and infant health using social media: Systematic Review. Preventive Medicine Reports. 2020 May 8:101113.
  28. Sullivan A, Elshenawy S, Ades A, Sawyer T. Acquiring and maintaining technical skills using simulation: initial, maintenance, booster, and refresher training. Cureus. 2019 Sep 23;11(9):e5729. PMID: 31723493.
  29. Thomas A, Gray MM, Burns B, Umoren R. EVAC: Evacuation of Vulnerable and Critical Pediatric Patients for Nurses. Cureus. 2020 May; 12(5): e8302. PMID: 32601574.
  30. Umoren R, Ezeaka VC, Fajolu IB, Ezenwa BN, Akintan P, Chukwu E, Spiekerman C. Perspectives on simulation-based training from paediatric healthcare providers in Nigeria: a national survey. BMJ open. 2020 Feb 1;10(2).
  31. Umoren RA, Gray MM, Handley S, Johnson N, Kunimura C, Mietzsch U, Billimoria Z, Lo MD. In-Hospital Telehealth Supports Care for Neonatal Patients in Strict Isolation. American Journal of Perinatology. 2020 Apr 8.
  32. Umoren RA, Sawyer TL, Ades A, DeMeo S, Foglia EE, Glass K, Gray MM, Barry J, Johnston L, Jung P, Kim JH. Team stress and adverse events during neonatal tracheal intubations: a report from NEAR4NEOS. American journal of perinatology. 2020 Dec;37(14):1417-24.
  33. Wong J, Manhas D, Campbell DM, Moussa A, Sawyer T. Procedural experience of Canadian neonatal-perinatal medicine fellows. J Clin Neonatol. 2019 Jan;8:47-53.
  34. Hippe DS, Umoren RA, McGee A, Bucher SL, Bresnahan BW. A targeted systematic review of cost analyses for implementation of simulation-based education in healthcare. SAGE Open Medicine. 2020 Mar;8:2050312120913451.
  35. Kukora S, Batell B, Umoren R, Gray MM, Ravi N, Thompson C, Zikmund-Fisher BJ. Hilariously Bad News: Medical Improv as a Novel Approach to Teach Communication Skills for Bad News Disclosure. Academic pediatrics. 2020 May 7.
  36. Keilman AE, Umoren R, Lo M, Roberts J, Yoshida H, Hartford E, Patrao F, Burns B, Fenstermacher S, Masse E, Reid J. Virtual protective equipment: Paediatric resuscitation in the COVID-19 era. BMJ Simulation and Technology Enhanced Learning. 2020 May 17:bmjstel-2020.
  37. Thomas A, Gray MM, Burns B, Umoren RA. EVAC: Evacuation of Vulnerable and Critical Pediatric Patients for Nurses. Cureus 12(5): e8302. doi:10.7759/cureus.8302
  38. Bucher SL, Cardellichio P, Muinga N, Patterson JK, Thukral A, Deorari AK, Data S, Umoren R, Purkayastha S. Digital Health Innovations, Tools, and Resources to Support Helping Babies Survive Programs. Pediatrics. 2020 Oct;146(Suppl 2):S165-S182. doi: 10.1542/peds.2020-016915I. PMID: 33004639.
  39. Rent S, Winter J, Umoren R, Vaucher Y, Nelson B, St Clair N, Bose C, Ehret D. Recent interest in global health among American Academy of Pediatrics Newborn Specialists. Journal of Perinatology. 2020 Nov. https://doi.org/10.1038/s41372-020-00869-8
  40. Litke-Wager C, Delaney H, Mu T, Sawyer T. Impact of task-oriented role assignment on neonatal resuscitation performance: A simulation-based randomized controlled trial. Am J Perinatol. 2020. Jan 3. Online ahead of print. PMID: 31899928.
  41. Sawyer T, Johnson K. Neonatal intubation: past, present, and future. NeoReviews. 2020 May; 21(5): e335-e341. PMID: 32358146.
  42. Foglia E, Jensen E, Wyckoff M, Sawyer T, Topjian A, Ratcliffe S. Survival after delivery room cardiopulmonary resuscitation: A national registry study. Resuscitation. 2020 Jul;152:177-183. PMID: 31982507.
  43. Sawyer T. Educational strategies to improve outcomes from neonatal resuscitation. NeoReviews. 2020 July. 21(7):e431-e441. PMID: 32611561.
  44. Robinson K, Tang H, Metzenberg E, Peterson J, Umoren R, Sawyer T. Socially distanced Neonatal Resuscitation Program (NRP): A technical report on how to teach NRP courses during the COVID-19 pandemic. Cureus. 2020 Oct; 12(10): e10959. PMID: 33209520.
  45. Yeung J, Djarv T, Hsieh MJ, Sawyer T, Lockey A, Finn J, Greif R. Spaced learning versus massed learning in resuscitation: A systematic review. Resuscitation. 2020 Nov;156:61-71. PMID: 32926969.
  46. Sawyer T. Simulation training in extracorporeal cardiopulmonary resuscitation (ECPR). Acad Pediatr. 2020 Nov 13;S1876-2859(20)30578-7. PMID: 33189906.
  47. Sawyer T. Neonatal resuscitation: airway, breathing, and then chest compressions. Resuscitation. 2020 Nov 9;S0300-9572(20)30549-9. PMID: 33181228.
  48. Ali N, Lam T, Gray M, Clausen D, Riley M, Grover T, Sawyer T. Cardiopulmonary resuscitation in quaternary neonatal intensive care units: A multicenter study. Resuscitation. 2020 Dec 23;S0300-9572(20)30607-9. PMID: 33359416.
  49. Brei BK, Neches S, Gray MM, Handley S, Castera M, Hedstrom A, D'Cruz R, Kolnik S, Strandjord T, Mietzsch U, Cooper C. Telehealth Training During the COVID-19 Pandemic: A Feasibility Study of Large Group Multiplatform Telesimulation Training. Telemedicine and e-Health. 2020 Dec 30.
  50. Burns R, Gray M, Peralta D, Scheets A, Umoren R. TeamSTEPPS online simulation: expanding access to teamwork training for medical students. BMJ Simulation and Technology Enhanced Learning.:bmjstel-2020.

 

Chapters 2019-2020

  1. Sawyer T, Ali N. Resuscitation of the Newborn. In: Gomella T, ed. Neonatology: Management, Procedures, on-Call Problems, Diseases, and Drugs. 8th Ed. Stamford, Conn: Appleton & Lange; 2020: 19-30
  2. Sawyer T, Gray MM, Umoren RA. Manikins and Task Trainers. AAP Neonatal Simulation Guidebook. American Academy of Pediatrics. Forthcoming in 2021.
  3. Sawyer T, Gray MM, Umoren RA. Umbilical Line Placement. AAP Neonatal Simulation Guidebook. American Academy of Pediatrics. Forthcoming in 2021.
  4. Umoren R, Rybas N. Who Am I as a Healthcare Provider?: Identity and Transformative Learning in Virtual Environments. In Virtual and Mobile Healthcare: Breakthroughs in Research and Practice 2020 (pp. 1028-1043). IGI Global.
  5. Umoren RA, Thomas P. Immersive Learning: Virtual and Augmented Reality. AAP Neonatal Simulation Guidebook. American Academy of Pediatrics. Forthcoming in 2021.