The Amount of Supervision Trainees Receive during Neonatal Resuscitation is Variable and Often Dependent on Subjective Criteria

OBJECTIVE: Measure variation in delivery room supervision provided by neonatologists using hypothetical scenarios and determine the factors used to guide entrustment decisions. STUDY DESIGN: A survey was distributed to members of the American Academy of Pediatrics Section on Perinatal Pediatrics. Neonatologists were presented with various newborn resuscitation scenarios and asked to choose the level of supervision they thought appropriate and grade factors on their importance in making entrustment decisions. RESULTS: There was significant variation in supervision neonatologists deemed necessary for most scenarios (deviation from the mode 0.36–0.69). Post-graduate year of training and environmental circumstances influence the amount of autonomy neonatologists grant trainees. Few neonatologists have objective assessment of a trainees’ competence in neonatal resuscitation available to them and most never document how the trainee performed. CONCLUSION: Delivery room supervision is often determined by subjective evaluation of trainees’ competence and may not provide a level of supervision congruent with their capability.