Open Access Open Badges Research article

Acute Care of At-Risk Newborns (ACoRN): quantitative and qualitative educational evaluation of the program in a region of China

Nalini Singhal1, Jocelyn Lockyer1*, Herta Fidler1, Khalid Aziz2, Douglas McMillan3, Xiangming Qiu4, Xiaolu Ma5, Lizhong Du5 and Shoo K Lee4

Author affiliations

1 Faculty of Medicine, University of Calgary, Calgary, AB, Canada

2 Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada

3 Faculty of Medicine, Dalhousie University, Halifax, NS, Canada

4 Faculty of Medicine, University of Toronto, Toronto, ON, Canada

5 Children’s Hospital of Zhejiang University School of Medicine, Hangzhou, People’s Republic of China

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Citation and License

BMC Medical Education 2012, 12:44  doi:10.1186/1472-6920-12-44

Published: 20 June 2012



The Acute Care of at-Risk Newborns (ACoRN) program was developed in Canada for trained health care providers for the identification and management of newborns who are at-risk and/or become unwell in the first few hours or days after birth. The ACoRN process follows an 8-step framework that enables the evaluation and management of babies irrespective of the experience or expertise of the caregiving individual or team. This study assesses the applicability of the program to Chinese pediatric practitioners.


Course content and educational materials were translated from English into Chinese by bilingual neonatal practitioners. Confidence and knowledge questionnaires were developed and reviewed for face and content validity by a team of ACoRN instructors. Bilingual Chinese instructors were trained at the tertiary perinatal centre in Hangzhou Zhejiang to deliver the course at 15 level II county hospitals. Participants completed pre- and post-course confidence and knowledge questionnaires and provided feedback through post-course focus groups.


216 physicians and nurses were trained. Confidence and knowledge relating to neonatal stabilization improved significantly following the courses. Participants rated course utility and function between 4.2 and 4.6/5 on all items. Pre/post measures of confidence were significantly correlated with post course knowledge. Focus group data supported the perceived value of the program and recommended course adjustments to include pre-course reading, and increased content related to simulation, communication skills, and management of respiratory illness and jaundice.


ACoRN, a Canadian educational program, appears to be well received by Chinese health care providers and results in improved knowledge and confidence. International program adaptation for use by health care professionals requires structured and systematic evaluation to ensure that the program meets the needs of learners, reflects their learning styles, and can be applied in their setting.

Newborn care; Newborn stabilization; Life support course; Acute care of at risk newborn; Continuing professional development; Continuing education