Difficult recruitment on top of high percentage of loss to follow-up.

The Neonatal Resuscitation Program (NRP) recommends providers renew their certification every 2 years. However, many Neonatal Intensive Care Units (NICUs) in Canada face challenges of significant budget cuts in training and a large number of caregivers to train with a high turnover rate. This situation makes it difficult for managers and nurse educators to ensure up-to-date certification and competence for all clinical staff. In addition, considering that only 0.1% of newborns will require cardiac massage and/or epinephrine, health care professionals' exposure to critical events is low to insure maintenance of expertise. Furthermore, it is shown that there is a significant decrease in knowledge among learners who have undergone specific training after only 3 months. This is worrisome considering that some nurses will not renew their certification if the course is not paid for by the employer, or if they are not released from clinical duties to attend. While keeping in mind the various required components of NRP training: book reading, online exam, performance stations, Integrated Skills Station Assessment (ISSA) and simulations, we would like to assess the educational and financial impact of a new educational strategy developed as to allow more nurses to be retrained thus ensuring maintenance of their neonatal resuscitation expertise.

Inclusion Criteria:

• Newly recruited ( in the last 3 months) neonatal and delivery room registered nurses from level 2 and 3 perinatal centers

Exclusion Criteria:

• Registered nurses that have already completed a NRP training in the past.