INTERNATIONAL CONNECTIONS Simulation and Neonatal Nursing Education Manal Kassab, BSN, MSN, PhD and Carole Kenner, DNS, RNC-NIC, FAAN Our world is shrinking due to computerized linkages and the mobility of society, and information is shared rapidly around the world. Newborn and infant health issues are global ones. In efforts to acknowledge the international community, each Newborn and Infant Nursing Review issue presents a column that highlights care-related issues from a featured country or region of the world. This month, Australia is featured. Our guest author is Mrs Manal Kassab, BSN, MSN, PhD, and Regional Network Contact for the Council of International Neonatal Nurses for Australia. This month's article focuses on Simulation and Education. Keywords: Simulation; Neonatal; Education Health professionals need, at some point, to build their medical skills while being trained using live patients. However, this could oppose the obligation of providing optimal care and insuring the safety and well-being of patients. 1-3 Therefore, applying what has been taught in a replicate clinical environment is considered one of the best ways to prevent medical error and manage any risk to the patient. This process of learning has been followed since the 16th century and is applied to gain the required skills before going to the real clinical settings. 1-4 Some common examples are the application of first injection by students on an orange, rehearsing medical interviews while role-playing, or practicing physical examina- tions on patient actors. Although such a way is used by many institutions, it is unsystematic, is traditional, and lacks the replication of real clinical environments. Human Simulation-Based Learning The advance in medical technologies required the develop- ment of traditional ways of medical training to follow a more advanced way that can replicate clinical practices on humans in a safe environment. This process is called human simulation- based learning. Simulation education aims to imitate reality while offering a skills-based clinical experience in a safe and secure environment. 5 In this way, students are able to replicate some or nearly all of the essential aspects of a clinical situation. The situation could be more understood and managed by the students when it occurs in a real clinical practice. 6 In addition, this way of teaching gives the chance of repeating practice to consolidate learning and develop required psychomotor competence or skill. 7,8 Moreover, it assists the application and learning of the required skill within a simulation context. Simulation-based learning has been recommended as an effective teaching method and is recommended over other teaching methods. 9 However, health care has lagged behind in simulation applications for several reasons, including cost, lack of rigorous proof of effect, and resistance to change. 1 The use of simulation-based learning wherever feasible could help in protecting patients from not being used as conveniences of training. These suggested barriers should be considered and explored carefully to help in the ease of applying such an educational method to improve clinical competence and impact on patient safety and error reduction. This is especially true in neonatal education where we have the most vulnerable patients. Trend This trend to use simulation in nursing education is not new because many countries have done so. But in neonatal nursing, its use has been limited until the last decade. In Australia, a leader in distance education and technology neonatal education has embraced this medium. For instance, high-fidelity simulation using an infant simulator and lifelike clinical scenarios are used in teaching neonatal resuscitation. The infant simulator consists of actual equipment and monitors that model's physiologic and other required changes in such a case. Some of the features of the realistic From the Faculty of Nursing, Midwifery and Health, University of Technology, Sydney, New South Wales, 2007, Australia; Bouvé College of Health Sciences, Northeastern University; and Council of International Neonatal Nurses, Inc, West Roxbury, MA 02132. Address correspondence to Manal Kassab, BSN, MSN, PhD, Faculty of Nursing, Midwifery and Health, University of Technology, Sydney, New South Wales, 2007, Australia. E-mail: manal_kassab@yahoo.com. © 2011 Elsevier Inc. All rights reserved. 1527-3369/1101-0393$36.00/0 doi:10.1053/j.nainr.2010.12.006