NIDCAP Fellowship
The Newborn Individualized Developmental Care and Assessment Program (NIDCAP) Fellowship
Overview
NIDCAP, the Newborn Individualized Developmental Care and Assessment Program, through neurobehavioural observation guides the care of infants in the NICU, to promote the best possible trajectory for their ongoing brain development. Edmonton is set to become the first NIDCAP Training Centre in Canada, with plans to formally open in 2016.
The Edmonton RCT of NIDCAP (Pediatrics 2009; 124:1009) showed that infants who received NIDCAP-based care had shorter lengths of stay in hospital, less chronic lung disease, and were less likely to have cognitive delays when seen at follow up. Thus, our Northern Alberta Neonatal Program’s eventual goal is NIDCAP based-care at all of our Edmonton-area NICUs / ICNs.
While all NPM trainees in the Edmonton Neonatal-Perinatal Medicine Program will learn the core concepts of neurobehavioral development of the preterm infant and the principles of NIDCAP-based care, trainees also have the opportunity to obtain additional training and certification in NIDCAP Behavioural Observation during their subspecialty training.
Training and certification in NIDCAP is a significant time investment requiring dedicated time in second-year and application for a third-year of training. In addition, NPM trainees interested in NIDCAP training and certification should generally choose a NIDCAP-related scholarly project.
Training Experience
In concert with the standard first year core training in NPM, trainees interested in pursing NIDCAP training and certification will be provided with readings on NIDCAP, and time set aside for discussion and reflective supervision. The NPM trainee is encouraged to attend monthly meetings of the NIDCAP Multidisciplinary Team during this time.
In the second year, formal didactic instruction in NIDCAP Observation by Trainer is provided (approximately 3 days are required for the introductory classroom and bedside teaching). Other trainees, both from Edmonton and other centers, are to be included in these didactic teaching sessions. Subsequently, the trainee will need protected time to complete NIDCAP training; a minimum of 3 days protected time per month, on average over the year. In addition, at least 2 days per year will be scheduled as workdays with the Trainer to ensure that training is proceeding as expected. Allowances will be made such that trainees will still complete other core NPM rotation requirements in the second year.
The trainee will do independent neurobehavioural observations of infants in the NICU / ICN on their NIDCAP dedicated days, to become skilled at the interpretation of infant behaviour and writing of reports that will guide care giving. The Trainer will review these observations and reports at intervals. NIDCAP reports are written in parent-friendly, supportive language. This can be challenging for physicians who are trained to write medical summaries in scientific / technical language with an emphasis on ‘problems’ and is in itself an educational goal of the NIDCAP training.
Toward the end of the second year, but at least by the first half of the third year, the trainee will observations of one infant are done from admission to discharge home, as the trainee leads the clinical care team in relationship based, behaviour guided care. One day per week protected time is recommended during the AP. Ideally, clinical service rotations will not occur during the 3 to 4 months of the NIDCAP AP. When the AP is satisfactorily completed, a Reliability day is scheduled, and if successful, the trainee is awarded Certification as a NIDCAP Professional.
During the second and third years, a clinical project / research study related to NIDCAP is highly encouraged (generally this project additionally meets the requirements of “scholarly project” for the NPM core subspecialty training). The project should also be planned at the end of first year or early in second year. The time required for this scholarly project will be in addition to the protected time for NIDCAP training specified above. The trainee would be expected to present this work at national / international meetings and/or at the NIDCAP Trainer’s Conference held annually.
Further details of the NIDCAP Training Process are available on the website of the NIDCAP Federation International
Additional Information
NPM trainees who wish to consider training and certification in NIDCAP Neurobehavioural Observation during NPM Residency should discuss this during the first year of subspecialty training with Dr. Juzer Tyebkhan, Neonatologist and NIDCAP Trainer in Training. In addition, NPM trainees should discuss this interest with the Program Director and members of the scholarly oversight committee to ensure that NIDCAP training and certification fits the trainee’s career goals and interests.