Master of Advanced Studies in Neonatology

00:00:01: Welcome to Neonatology

00:00:02: Now, the official

00:00:04: podcast

00:00:04: of The European School

00:00:06: Of Neonotology.

00:00:08: Here at

00:00:08: Neonautology Now we are shining a light

00:00:11: on real-world experiences

00:00:13: of

00:00:13: world renowned experts in perinatal medicine.

00:00:16: Together

00:00:17: you will learn from top medical doctors researchers

00:00:21: and opinion leaders

00:00:22: To better

00:00:23: understand how we can improve

00:00:25: professional neonatal care Europe

00:00:27: And beyond.

00:00:29: It's not just

00:00:30: about the science, it is all about stories and experiences

00:00:34: shaping

00:00:34: this critical

00:00:35: field of medicine.

00:00:37: And now

00:00:38: without further

00:00:39: ado let me introduce you to your host a seasoned neonatologist

00:00:44: and our guide

00:00:45: for these fascinating

00:00:46: conversations Professor Mario

00:00:48: Rudiger.

00:00:49: Mario

00:00:50: take it away.

00:00:52: Welcome to new episode of Neonatology Nord The podcast of European School Of Neonautology.

00:00:58: the topic of this special episode for today is Master of Advanced Studies in Neonatology.

00:01:05: I'm Professor Riediger and my guests are Alessandra, Leonis, Susanna, Pablo all our students from the European School of Neonautology.

00:01:18: So welcome to NeonAutology now with a podcast where we explore innovation science and training in neonatal medicine.

00:01:25: So today's episode is especially exciting because we are talking about the master of advanced studies in neonatology, which was developed by The European School Of Neonatology or ESN.

00:01:36: This program is shaping the next generation of neonatologists across Europe and beyond And it combines evidence-based medicine digital learning clinical practice and international collaboration.

00:01:48: Joining us today our students from the programme itself so its Alexandra from Dublin Leoni from Zurich Susanna from Targu, Morris in Romania and Pablo from but Alona Spain.

00:02:00: So all of them are around Europe.

00:02:02: that's great.

00:02:03: nice to see you here.

00:02:05: I can't see your and use the listeners can listen to you.

00:02:08: so welcome to Neonatology.

00:02:10: now And in order To Present my guests i would invite first.

00:02:16: maybe susana Can You introduce yourself?

00:02:20: Nice to See you and us too Be here with you.

00:02:24: Yes I'll.

00:02:27: as you said, I live and work in Turgu Muresh which is a small town In the middle of The country Romania And it has around one hundred twenty thousand residents and i am working in a secondary level hospital taking care of premature infants.

00:02:57: Okay, Alessandro, what about you?

00:03:01: Hello everyone and thanks for this opportunity to speak today!

00:03:05: I am Italian, as you can hear from my accent but i moved to Ireland to do my training in pediatrics with special interest in neonatology here in Dublin.

00:03:16: I'm currently working at one of the quaternary centres of the nation called CHI Tempo Street and I mean a pediatric ICU rotation And I'm soon leaving for my fellowship in Australia, Melbourne.

00:03:33: Just in RCH first and then the Monash and just accept it they offer this morning.

00:03:39: so i am pretty excited.

00:03:40: Excellent congratulations that's great!

00:03:43: You see go to the top best neonatal units of the world.

00:03:49: Pablo what about

00:03:49: you?

00:03:51: Hello It is nice be able speak with all and also for those that we can see.

00:03:58: So my name is Pablo, I work in Barcelona and one of the biggest hospitals here which is San Juan de Teo And i work both at the PQ as an attending but also i'm uh an attending in the transport unit.

00:04:14: We've got a dedicated specialising transport unit That does both pediatric and neonatal transplants And we cover the whole of Catalonia, so that means... ...that we are on call for about a population around eighty million people.

00:04:34: Obviously there's less children but we cover up very big territory.

00:04:40: It is up to Andorra.

00:04:44: We're talking like four or five hours in the road sometimes and it's very exciting.

00:04:49: Besides this they also do NICU in another center which is called Sampau, a secondary hospital here.

00:04:58: Okay thank you!

00:05:00: So now move to Switzerland.

00:05:01: that's maybe smaller than Catalonia.

00:05:04: so Leonie what about you?

00:05:07: Yes, thank you so much Mario for the introduction and nice to see you.

00:05:11: And welcome to the audience!

00:05:13: So as Mario said I'm from a small country of Switzerland... ...and i am lucky enough to work at the tertiary in NICU in Zurich at the university hospital there.. ..and yes I just finished up my residency in pediatrics and started actually my second month of my neonatal fellowships.

00:05:34: It's great to be part this group and congratulations to Alessandro for this wonderful news.

00:05:41: Excellent, so I'm really looking forward our discussion today.

00:05:44: So many guests in the podcast.

00:05:47: it's a rare event actually For listeners who may not yet know the program.

00:05:51: The Master of Advanced Studies in Neonatology is a postgraduate educational programme And its assigned for pediatrician and neonatal professionals Who want to structure advanced training in neonatal medicine.

00:06:04: So, I think what makes it unique is that its competency-based internationally connected mostly digital and flexible And deeply integrated into clinical practice.

00:06:15: The curriculum covers topics such as respiratory support sepsis family centered care transport medicine and so on.

00:06:23: It also uses modern educational concepts like entrustable professional activities workplace based learning and transfer to practice assignment.

00:06:35: And finally, it's also recently been certified by the Foundation for International Business Administration Accreditation.

00:06:48: so now its accredited?

00:06:51: So that is very good!

00:06:54: What motivated you to apply for Master of Advanced Studies in Neo-Natology?

00:07:01: Well, you actually pointed it out already because that was a wonderful summary.

00:07:05: It was exactly that.

00:07:07: so I knew when going into my clinical fellowship and looking for an opportunity to structure my own learning path in this endeavour.

00:07:18: And then, my attending actually at the University Children's Hospital suggested a rather new master's programme and when I read it immediately thought that is exactly what i'm looking forward to help me parallel to my clinical education, helped me structure and get maybe a bit wider perspective on neonatology especially in let's say more global world.

00:07:43: And see what is beyond the country of Switzerland.

00:07:47: up until now I have not been disappointed.

00:07:51: Was there specific clinical experience that influenced your decision Pablo?

00:07:57: I

00:08:01: had an attending at my previous workplace where i was, suggesting that i joined the programme as well.

00:08:08: And for me you know... The path into neonatology-I don't know about you guys in other countries but.. In some countries like Spain You get to do a whole lot of pediatrics and your residency But then the sub steps towards subspecialty training are not as well devised or guided.

00:08:29: these happens in other settings such as for example the UK, which I think has everything... Has a good path so to speak.

00:08:40: And i know that you guys and some other countries do have those sub steps into subspecialty training but it's really about whether or not Me myself, I finished my residency programme and on the first year in attending went into NICU.

00:09:03: And obviously there's a lot of learning as you go because mind-you your own call.

00:09:10: so that is quite frightening!

00:09:15: It was very hard at the beginning.

00:09:17: also you don't have enough experience to draw from and that's coupled with the need for reassurance in your theoretical.

00:09:28: So I guess those two things make made me look for programs too, just get better really?

00:09:37: And also together a more structured approach to practice the clinical practice.

00:09:46: so yeah i think

00:09:49: Okay, so Susanna how does the program differ from the opportunities educational opportunities in Romania for instance?

00:10:00: For instance in Romania.

00:10:02: I did my specialization In an anthology first and i didn't have to go And do first the pediatrics subspecialty of Neonatology.

00:10:18: So I became a attendant in Neonatalogy before, i was even pediatrician resident after

00:10:27: finished

00:10:28: and got my specialty in Neanatology entered into the residence of Pediatrics it.

00:10:38: this was only in my decision.

00:10:40: And I did so because i consider that it's necessary for continue My learning path and also, Because I observed that I have So many fields that are missing from my Neonatology path?

00:11:09: most, a more profound learning path.

00:11:14: So after that I entered and...I didn't mention but i'm also teaching pathophysiology in our town.

00:11:24: so this was combined position that did not allow me to travel for traditional in person training possibilities.

00:11:41: So that's why I was searching online, four programs that fits my personal shadow from the university and also from hospital And thats how i discovered ASM program.

00:12:06: Okay, so Alessandro one of the strengths of CSN program is its European and international perspective.

00:12:14: So how has learning with colleagues from different countries influenced your clinical thinking?

00:12:22: It's been wonderful so far like we always compare our actual practice that even if in medicine We should do all this stuff In practice.

00:12:33: So, we shared lots of protocols.

00:12:36: We share the newest evidence-based medicine from all over Europe because we are in a wide and broad group of colleagues.

00:12:47: And actually I think one of my protocol... ...and the protocol is for another girl that belongs to our group of students.

00:12:57: trainees are actually being shared in the group for implementation.

00:13:01: In other hospitals as well,

00:13:04: or

00:13:04: like just to check if it's possible... ...to apply the same protocols in another unit.

00:13:11: so its really rewarding and interesting.. ..to see how Neonatology has been developed and professed in other countries.

00:13:22: So Pablo what about you?

00:13:25: Yeah exactly I think that the best of experiences.

00:13:29: You know, one really good thing is that all the materials we get they are really looked after and then it gets the latest evidence which he's really nice this year being updated constantly.

00:13:40: but for me great point is to have these discussions with a small group people that are very knowledgeable about what they do in how they do it also at same time.

00:13:53: so well Sandra said are ideally supposed to be doing the same but we don't put them in the end sort of do as well.

00:14:00: you know because like you see that other people have the same ideas or the same doubts sometimes even you know like and then.

00:14:12: that everywhere there's standards of practice, but then every where those things seem to be untouchable and are always done in a certain fashion just because someone said so.

00:14:24: And again if they work you know it is really nice and dynamic sharing all the knowledge.

00:14:33: I don't know... It opens up new thoughts mind thoughts for oneself, but also on the other hand it reassures you.

00:14:47: Because as I always say this to residents if nothing is black or white normally in medicine.

00:14:54: so If your doubting between A B and C It's okay Either course might be ok.

00:15:00: You just have reason.

00:15:02: why do it In order me buy it.

00:15:05: But if you are doubting in between A & Z Then we've got a problem And i need too.

00:15:14: It's very interesting.

00:15:17: That is a part I like for myself as well, going around the world seeing how people are doing it and sometimes i'm surprised to see babies surviving despite of big differences not because of their treatment.

00:15:34: So Leone did you discover any specific differences in your native practice between countries?

00:15:43: Well, I actually feel quite the same as Pablo and Alessandra.

00:15:47: There are certain differences And it's very interesting how culture and different hospitals deal with different questions sometimes the resources other countries have and deal with in terms of caring for very sick babies, how they cope with it.

00:16:08: I personally think that studying peer-to-peer exchange we have is a great resource because myself being in this lucky position having like tertiary clinic in a first world country and then I hear from my colleagues who have other experiences or have had humanitarian practice done, show me how different they approach problems.

00:16:37: And as you said still the babies are thriving... The families are thriving!

00:16:42: For for me especially it's very good reminder that we We can critically overthink what we do here.

00:16:52: And it's very interesting and I see that as a big, big pro point for this program.

00:17:01: So Alessandro, Do you remember the situation where something you learned during the programme directly changed your daily practice?

00:17:22: happy with the training I've been given here in Ireland.

00:17:26: compared to my colleagues, we are at same level.

00:17:30: But

00:17:30: something that changed my practice is they're willing know more about other hospitals and other way of doing Neonatology as we said so far.

00:17:45: So technically in practice i think following the standards of European and international standard.

00:17:57: One colleague in our group is following the IOA protocol strictly, they are having amazing outcomes on their newborns.

00:18:09: therefore I want to keep working on that.

00:18:13: so technically speaking it didn't change my actual practice but impractical.

00:18:21: I want to do even better, so this sharing of ideas is making me a better.

00:18:27: So Susana did you change something in your unit after having some lessons?

00:18:33: Yes i particularly wanted to mention the fine course which was huge milestone on my education because it totally changed interview, how to reach out to the tiny patients and what you need to focus on.

00:18:59: To be a good doctor for them?

00:19:03: And to meet their needs.

00:19:06: so because we are focusing on protocols sometimes we forget to their needs and to consider them, not only the object of our work

00:19:26: also.

00:19:27: The

00:19:28: soul

00:19:30: of the whole thing.

00:19:32: so that was a very good course And I'm so glad that i took it.

00:19:40: So master programme is largely an online and hybrid program.

00:19:46: So Alessandro, what surprised you most about the digital learning experience?

00:19:52: I love the flexibility.

00:19:55: The fact it's very international and our tutor is following us closely with a good feedback loop.

00:20:16: what has been studied and you know, explored during the self-led teaching.

00:20:25: So I really like it!

00:20:28: And so Leoni which online learning format has been most effective for you?

00:20:33: Lectures cases discussions simulation...

00:20:37: i actually liked most case series step-by-step approach, so you start with the case and then follow up.

00:20:50: For me it was very easy to get into a more clinical practice approach even while I'm sitting at my laptop in my office!

00:21:00: So I really like that.

00:21:02: yes.

00:21:04: Pablo how do we balance demands of clinical work for online education?

00:21:11: It is not very easy.

00:21:13: infact.

00:21:15: I think that's something we all do come across sometimes, because i don't know about you guys but my tutoring group has a bit of trouble sometimes scheduling meetings and go into an ending never-ending like doodles to try and find um...a time schedule that works.

00:21:37: But eventually even if it is at the very end I think that it's nice just because the whole atmosphere, its relaxed and nice.

00:21:50: then about sharing not really judging.

00:21:54: Just commenting on very differences.

00:21:58: i think thats easy to follow.

00:21:59: but yeah definitely you know i'd say despite all of good things we've said which are real The only minor thing thats a bit difficult sometimes Its balancing shifts and the meeting times.

00:22:17: But as Alessandra, Leonie and Susanna said before it's great that you can do this at your own time!

00:22:24: And I have to say is more than enough which is always appreciated.

00:22:31: So maybe Leonie can you shortly explain how does a program work?

00:22:36: How big are groups online done or self-study

00:22:41: etc.?

00:22:42: Yes, so I'm happy to.

00:22:44: So my tutor group... ...I think we're six people and also very internationally which is great!

00:22:50: And then as Alessandro mentioned a thought through the digital platform was actually impressed by how it's done.

00:22:59: It's very intuitive.

00:23:01: You start with the module Meaning.

00:23:03: you have different parts of the module, which is usually one topic.

00:23:06: As I said before for example Unatal Transport or BPD and then your work through those models And every module has like a background part in beginning where you get your background information.

00:23:20: You can dive into that topic.

00:23:21: sometimes there are additional resources And then you work through case series, or questions that can be answered.

00:23:30: You type in your answers and when typed into the answer there is usually a solution given.

00:23:35: so you compare what.

00:23:37: maybe the program director put it on if you're in line... Then you work though.

00:23:43: those modules and meet-ups as Pablo said sometimes need some doodling until you find an appointment And then you work through it.

00:23:53: As I was lucky enough to have two different tutors by now, because of one session had to be someone else... ...I see that every tutor also has different approaches.

00:24:03: so sometimes one works through the background with you and we engage in a discussion which is very lively and I feel very engaging And another tutor might go a different route, or maybe only to the questions and discuss that.

00:24:19: Both of them actually asked what for this tutor group would be like so it was very individualized.

00:24:26: we had great discussion.

00:24:28: then these modules are done.

00:24:30: you can go on next because they're clinically driven topics.

00:24:35: I myself always take something from the tutor session but also my self-learning back to my clinical day work, that is very great.

00:24:47: May I add also?

00:24:49: The good thing of the modules is we go through a module at time but then they are available throughout year or full master to be re-looked at and restarted.

00:25:05: so there's open source at end of the module.

00:25:10: That's important And so you were already talking about the medical aspect, but a program also strongly emphasizes infant and family center development with care.

00:25:21: So Susanna how has this changed?

00:25:24: The way you communicate as parents in the NICU?

00:25:32: Yes It was very interesting to see that my colleagues have different approaches because our strategy was not to promise anything that can backfire sometimes.

00:25:49: So we were shutting them out a little bit, so-to say in order keep themselves safe from being disappointed if something is not working as they see it but As I saw in different scenarios, in different hospitals although they involve the parents.

00:26:18: They are not that disappointed That we expected to be.

00:26:24: so i assume that We can take a step forward and invite them To be more active And let them do More and I implemented some staffs in our department, you know order to keep the mothers with babies involving them into their daily care.

00:26:59: That was something from this master class that i took implemented.

00:27:10: So I think these parent, patient or the interaction with parents has a biggest difference between different countries.

00:27:19: so as far as i experienced though the attitude of physicians are very different in different countries and that's it's very interesting aspect.

00:27:29: Pablo what challenges do you thing still exist when implementing family centers care and busy NICU settings?

00:27:39: Well, I think that...I don't know what's your thoughts on this?

00:27:46: but I think society is quickly evolving and somehow find interaction with technology and globalisation as a whole have been shaping more the relationship that we physicians developed with families.

00:28:08: And I sometimes, especially in them so-called developed countries or high income countries... ...I find that we sometimes have the danger of switching onto a clienty based.

00:28:33: Protocol or way of functioning, you know.

00:28:36: because sometimes I think that what we have to remind them is That their children are theirs and then we're just trying together The best environment for them all to thrive as a family And come together in.

00:28:54: Also i do believe that We have this sort of move around technology which seems to be, you know sometimes I feel that there's an excess of technology and babies are primarily nurtured by the relationships they devise with their own parents.

00:29:15: And we're talking real relationship.

00:29:18: so held loads of kangaroo care direct eye contact being Talk ad being spoken to and listening to the voices.

00:29:30: And even being sung at you know, so I think that fostering real life interaction is one of them things.

00:29:39: and i'm just saying this because One of the many ideas That they've seen on congresses for example was something like a live video cam incubator To let their parents sort of see the child on remote at all times.

00:29:56: And I think that's, you know okay as all technologies could have its good effect but there is a danger off going online and missing the life.

00:30:10: That's very good point so we could ever enter.

00:30:12: podcast on this.

00:30:15: It some addition it not main idea.

00:30:18: i've just been to speakestown in low-middle income country And I was visiting some units and experienced, there were a lack of nurse stuff.

00:30:28: But the mothers managed to do kangarooing.

00:30:31: even this is an eight hundred gram baby.

00:30:34: So the NICU was full of mothers which are very kangaroos with their babies twenty four hours per day.

00:30:41: so i was surprised that it's a good example for my unit That everything can be done!

00:30:50: So by coming to the program back, Alessandra what has been biggest challenge so far and for participating in this program?

00:31:03: And how did you manage it?

00:31:05: Probably Pablo said that already is time.

00:31:09: managing a full breakdown call with the time schedule of each and every one.

00:31:16: That's main challenge.

00:31:18: What about Juliani?

00:31:21: Yes, I mean this as well.

00:31:25: It is rather hard because the programme was rather new so a lot of us are doing it besides full rotation.

00:31:32: I could imagine if something that's more established and maybe gets more recognition hopefully from clinical directors.

00:31:41: there can be an arrangement or protected time for something like that, but at the moment a lot of us are doing it just on top of one hundred percent schedule.

00:31:52: So that is a challenge and to be very honest with you I think sometime procrastination gets the best of me.

00:31:57: so It's usually the case That i am wonderfully aware.

00:32:02: we have a meetup And then I realize wow there're still two models to go.

00:32:05: so I have to crunch them in.

00:32:07: But this more a me factor than program factor.

00:32:10: Of course its a challenge To finish up good quality work in your self-study and the case series, have it ready when meeting is.

00:32:21: That's

00:32:22: a very human factor for things.

00:32:25: so I know that as well!

00:32:27: What can

00:32:28: we do without procrastination right?

00:32:31: Exactly

00:32:33: but its good to have some external pressure.

00:32:35: thats always beneficial.

00:32:38: Thats all point of joining our program is that you are pushed to actually get better.

00:32:44: Yeah, so we're almost at the end of our podcast.

00:32:49: and So as I said, You Are The Future Generation?

00:32:52: You are the directors of the program in the future And so on... What do you think or how Do you see the future of Neonatal Education for the next ten years, fifteen years with Susanna?

00:33:03: what do you

00:33:07: thing?

00:33:09: It's gonna shift onto this somehow online hybrid education.

00:33:16: So it's gonna be based on online materials and small group case-based scenarios, more group talks And then onsite only the practical part.

00:33:32: so

00:33:34: probably It is going to be more accessible.

00:33:45: want to mention that I liked these case scenarios, which we had in our materials.

00:33:58: And they also embedded my teaching techniques.

00:34:02: so it's a very good way of learning and focusing on the more important things.

00:34:19: I think this would be a way to do more and achieve

00:34:26: more.

00:34:27: Okay, so Pablo what do you think?

00:34:30: which technology or innovation will most likely influence neonatal training in the future?

00:34:39: Well i think for one simulation probably is like equal the craze now.

00:34:46: So I think that probably most units are going to try and do that.

00:34:51: At least they would advise them too, because for instance you go every other course on either respiratory or ventilation or neonatal airway management And one of the things we encounter more is because we use NIV a lot, intubation skills just mentioned are diminishing all across the globe, I would say.

00:35:21: So for example simulation but like we're real hands-on simulation proper almost a real case scenario.

00:35:29: um simulation that's probably one of things it's gonna become more and more useful... We have fortunately to do a lot of that in my uh transport unit You know, not only for the technical skills that you need to have but also rehearse working under pressure and non-technical skill.

00:35:56: So communicating practice in a closed loop interactions leading in a respectful way so on.

00:36:03: I think it's really putting everything into practise.

00:36:12: So learning, talking about the future.

00:36:15: What do you think of an international standardized training program for becoming a neonatologist?

00:36:23: Yes I actually would have added that to your previous question because i love that aspect of this programme.

00:36:30: it compares different countries as well and takes a critical stance on different practices or i hope in medical education Particularly in neonatal care and pediatric intensive care where we have a vast load of evidence to support our therapies that move from more, you know... let's say secluded, maybe national guidelines to a more coherent European or global guidance where we can learn from each other but also use resources more effective.

00:37:05: I think at least in Switzerland... We are also struggling with shortage of doctors and educators sometimes so the technology could be a great resource cure a curriculum for training.

00:37:24: And I also do hope that not only in terms of like medical and physician inputs, but also more global approach to parental insight and nurses' insights.

00:37:38: because this collaboration is so valuable.

00:37:40: we could profit from more interdisciplinary curriculum in general.

00:37:47: So maybe we can move towards these things.

00:37:52: That's a very good task for you because you will do it in the future.

00:37:55: Okay So at the end and just a very quick rapid fire round short question, short answer Susanna Simulation training or bedside teaching?

00:38:11: Okay Leonie What is one innovation in neonatology that are most excited

00:38:18: about?

00:38:20: EIT?

00:38:24: Could you explain why?

00:38:26: Because I think it's a great resource for... individual-guided respiratory therapies.

00:38:34: It could be, it could be!

00:38:35: I'm just saying... Yeah

00:38:36: yeah.

00:38:37: so i am very much surprised.

00:38:39: that's not a quick answer because i did a lot of research in this one and i like it very much..i liked it for about ten or fifteen years or twenty years ago when i started and was convinced but i haven't found the device which is really came into practice.

00:38:58: Okay, so maybe I'm at that point where you were some

00:39:03: time ago.

00:39:04: That's excellent!

00:39:06: Go the way okay?

00:39:11: Pablo one word just a single word that describes Mars experience.

00:39:18: One Word is Difficult Career Transforming is a favorite

00:39:24: learning module so far.

00:39:26: All the current modules that I'm learning, it's my favourite.

00:39:37: That's

00:39:42: very good, excellent!

00:39:44: Alessandro coffee or tea during night shifts?

00:39:47: The first one is coffee and then for the rest of the night

00:39:51: tea.

00:39:52: Okay.

00:39:55: So Alessandra what Nikio skill?

00:39:57: every trainee should master?

00:39:59: early

00:40:00: communication with parents.

00:40:03: Okay, excellent.

00:40:04: So finally Leonie what's harder?

00:40:07: Intubation or work-life balance?

00:40:12: Work life balance!

00:40:15: Quite a good answer.

00:40:17: So that was very interesting to talk to you, and so as our listeners have learned the European Master of Advanced Studies in Neonatalogy represents more than a degree.

00:40:29: it's part of movement toward harmonized evidence-based neonatal education across Europe And It seems to be a lot fun.

00:40:38: As far I got from your response.

00:40:41: And to all students who are joining us today, thank you for sharing your experience and your passion of improving neonatal care.

00:40:51: To our listeners if you would like more about the European School Of Neonatürk G.U.

00:40:55: in the MASS program You can visit an ESN website and join the program.

00:41:02: Once again Thank you very much for your contribution For open words especially for time.

00:41:10: Bye

00:41:17: bye.

00:41:20: Thank you so much, Mario!