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James shares his experience of moving from candidate to instructor on the Advanced Resuscitation of the Newborn Infant (ARNI) course.
At Great Western Air Ambulance Charity (GWAAC) we are privileged to have a Critical Care Team made up of individuals with different specialisms, skills and interests. Specialist Paramedic in Critical Care (SPCC) James Yates is also an Advanced Paramedic in Neonatal Care for SoNAR — the South West’s Newborn Advice and Retrieval Team.
Not only does James share his neonatal knowledge with the rest of GWAAC’s Critical Care Team but he also trains other medical professionals, locally and nationally.
In 2021 James was one of the first paramedics in the UK to attend the Resuscitation Council UK course. Historically, paramedics were not eligible as they did not have regular exposure to complex and critically unwell neonatal patients, but this was something James could demonstrate due to his role as an Advanced Paramedic with SoNAR.
On completion of the course, James was identified as having instructor potential, but the course regulations had to be adapted to allow him to take up an instructor role. No paramedic had ever been offered a position as a faculty member before.
To achieve sign-off as an instructor from the Resuscitation Council course, James had to successfully teach two ARNI courses, with his performance as an instructor candidate critiqued and assessed throughout.
From candidate to instructor
In March 2023 James travelled from Bristol to Dundee as part of the faculty for the inaugural Scottish ARNI course.
There were 17 faculty members, 15 of whom were consultant neonatologists. James describes ARNI as a “very high-level course with a significant depth of observation and feedback to candidates.” To facilitate this the instructor-to-candidate ratios were small; there were 16 candidates made up of consultants, registrars, advanced neonatal nurse practitioners, senior neonatal nursing staff, and experienced midwives.
The course lasted two days, starting with some core lectures on day one and then a significant number of complex simulations to assess how the candidates managed the cases presented to them. During these simulations, the instructors assessed:
- The clinical management of the neonate
- Teamworking and leadership skills
- Decision making
- Communication skills.
The candidates also made their way around several detailed skill stations which looked at the expert delivery of essential lifesaving treatments, for example, intubation and chest drains.
James taught the chest drain skill station and the advanced airway skill station, drawing on his experience from both GWAAC and the retrieval team.
He then facilitated two simulations, with a heavy focus on team performance — something that he could confidently comment on, by once again drawing on his experiences with GWAAC.
James said that being invited to teach on the course was “extremely nerve-wracking and instilled a certain degree of self-doubt.” But it proved to be an extremely positive experience:
“I felt that my knowledge and skills were really valued and my unique perspective, drawn from the pre-hospital and neonatal roles that I have, added valuable experience to the multi-disciplinary team.”
After successfully completing this first course as an instructor candidate, James taught on a second course in Bristol in May 2023, where the faculty signed him off to become the first accredited ARNI instructor from a paramedic background in the UK. A huge achievement.
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I felt that my knowledge and skills were really valued and my unique perspective, drawn from the pre-hospital and neonatal roles that I have, added valuable experience to the multi-disciplinary team.