Tracheal Intubation Coaching in NICUs

Tracheal intubation (TI) is the most common life-saving intervention for resuscitation and
stabilization of critically ill neonates in Neonatal Intensive Care Units (NICUs).Recently,
video laryngoscopy (VL) has become available in neonatal clinical practice to allows trainees
and frontline providers to perform standard direct airway visualization (i.e., traditional
laryngoscopy) while the supervisor can simultaneously view a real-time video displaying what
the laryngoscopist is seeing. However, VL associated coaching during TI has not been
rigorously evaluated.The purpose of the study is to determine the efficacy of video coaching
training for neonatology attending providers on tracheal intubation procedural outcomes in
neonatal ICUs. The primary objective of this study is to determine whether the video coaching
skill training for neonatology attendings reduces the occurrence of adverse tracheal
intubation associated events among all tracheal intubations in neonatal ICUs over 2 years
before and after intervention. The secondary objectives are to 1) determine if video coaching
training is feasible to all neonatology attending physicians using train the trainer approach
with a remote simulation and 2) determine if the video coaching skill competency among
neonatology attending physicians who completed the training using a remote simulation

Inclusion Criteria:

1. VL coach: Neonatology attending physician position at each neonatal ICU, or Senior
trainees who are anticipated to graduate within next 6 months to become neonatology
attending physicians.

2. VL coach receivers: Trainees (medical students, residents, fellows except those
graduating within next 6 months) and frontline providers (nurse practitioners,
hospitalists, physician assistants, respiratory therapists, others who perform
tracheal intubations under attending physicians' supervision)

Exclusion Criteria: