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Support Instructor Preparation

Preparing and Registering S.T.A.B.L.E. Support Instructors

If a person is unable to attend an official National or Private Instructor course, but they wish to co-teach a S.T.A.B.L.E. Learner course with your teaching team, you may follow our Support Instructor preparation process outlined below so they may become registered as a Support Instructor. Please note, Support Instructors may not teach at any time without a Lead Instructor present. 

Support Instructor training is only available for those teaching the 6th edition. All Support and Lead Instructors will be required to Bridge to the 7th edition in order to access the 7th Edition Instructor Portal (slides, resources etc.). After the 6th edition is retired on March 31, 2025, a new 7th edition Support Instructor process will be implemented.

Please also review the PDF on this page as it contains information at the end regarding important information that will need to be completed by both the Lead Instructor and the Support Instructor Candidate as part of the final registration process.

Support Instructor Training by Registered Lead Instructors

This training option is intended for colleagues who wish to teach in collaboration with your teaching team. If they are from another facility or region, even within your hospital corporation, please do not proceed unless you have contacted the S.T.A.B.L.E. office to discuss their request and to ensure you have written permission from S.T.A.B.L.E. to proceed.

!!  Please read all steps of this document carefully before the Orientation to Support Learner Course. This will help ensure that registration of the Candidate as a Support Instructor may proceed without a problem. 

STEP 1. Candidacy Requirement, Registered Lead Instructor Experience, Training Course

  1. Determine whether the person (“Support Instructor Candidate, hereinafter referred to as “Candidate”) has the NICU experience to correctly interpret and present the S.T.A.B.L.E. Program content. If they do not meet this minimum requirement, they do not qualify to become registered as a Support Instructor.

SUPPORT INSTRUCTOR – Description and Responsibilities The Support Instructor may teach in collaboration with a Lead Instructor, but may not teach independently of a Registered Lead Instructor. 

Minimal Work Experience  Must have at least one year equivalent (> 2000 hours) of recent – within five years – level II SCN or level III or IV NICU experience or neonatal transport (see NICU level designations below)*

Knowledge and Expertise  The Candidate is familiar with the material in one or more of the S.T.A.B.L.E. program modules as follows:

Principles of hypoglycemia (causes and treatment), safe use of umbilical catheters, thermoregulation and physiologic consequences of hypothermia, neonatal chest x-ray interpretation, blood gas interpretation, neonatal respiratory diseases, pulmonary hypertension and shunting, use of assisted ventilation, resuscitation, assessment and treatment of shock, presentation and treatment of infection, CBC (complete blood count) interpretation, and offering emotional support to families in the newborn ICU.

*For NICU Level designations: II, III and IV (2, 3 and 4) as defined by the American Academy of Pediatrics, see: Levels of Neonatal Care: Policy Statement, Committee on Fetus and Newborn. Pediatrics, 130(3): 587–597.

  1. Specialty Care / Level II Special Care Nursery Provides care to infants > 32 weeks gestation and weighing > 1500 grams who are moderately ill with problems that are expected to resolve rapidly and are not anticipated to need subspecialty services.
  2. Subspecialty Care / Level III Neonatal Intensive Care Unit (NICU) Level II – plus able to provide sustained life support. Can provide comprehensive care for infants born < 32 weeks gestation and weighing < 1500 grams and infants born at all gestational ages and birth weights with critical illness. Able to provide a full range of respiratory support that may include conventional and/or high-frequency ventilation and inhaled nitric oxide. Can provide ventilatory support (endotracheal or nasotracheal intubation and positive pressure ventilation), care of umbilical venous and arterial catheters, intravenous medication administration, and care of unstable term and preterm infants.
  3. Subspecialty Care / Level IV NICU Level III – plus located in an institution with the capability to provide surgical repair of complex congenital or acquired conditions. Maintain a full range of pediatric subspecialists (medical, surgical, anesthesia) on site. Facilitates transport and may be involved with neonatal outreach education.

2. The Lead Instructor(s) or combination of Lead and Support Instructors who will ‘model’ the teaching of the Learner course must have prior experience teaching the course. See Step 4 – Instructor Team Experience below.

3. Set up a full-length Learner course. This course will serve as the demonstration course for the new Candidate(s), even if the Candidate has previously attended a Learner course.

STEP 2. Pre-Assessment and Mixed Module Post-testing Requirements

  1. The Candidate MUST take the pre-test proctored (closed book and in a work environment, not at home) and without the assistance of the Learner or Instructor manual, or any other resources while the test is being taken.
  2. 6th edition Pre-Assessment Passing Score:
    If the Candidate scores 70% or higher on the 6th edition pre-assessment, they may continue with Orientation to Support Instructor.
    If the student scores lower than 70% (more than 12 questions wrong) then that person is not a candidate for Support instructor training. Please do not submit their name on a roster as Orienting to Support. Alternatively, they may proceed with earning a Learner course completion card if they meet the other Learner Course Rules criteria.
  3. Quizzes and Testing.
    By the conclusion of the Orientation to Support Learner course, the Candidate must have a completed Quiz Answer sheet (the first 32 questions) and they must also take the 6th Edition Mixed Module post-test and PASS on the first try.
    Mixed Module post-test (8 questions) passing scores:

    • The Candidate must score ≥ 75% (0, 1, or 2 questions wrong), on the first try.
    • If the Candidate scores 3 or more wrong on the mixed module test, they are no longer a Candidate for Support instructor.
    • In the event of a mixed module post-test score of 3 to 4 wrong, the student is eligible for re-testing under the Learner Course Rules (found in the on-line roster section of the website). Upon passing, they may then earn a Learner course completion card.

STEP 3. Once it is determined that the Candidate has a passing pre-assessment score (≥ 70%) and can proceed with Orientation to Support, a 6th Edition Instructor Manual must be made available for the Candidate’s use during the Orienting to Support Learner Course presentation. S.T.A.B.L.E. strongly recommends that the Candidate owns their own Instructor Manual so that they may take notes in the manual and have it available whenever they teach.

Therefore, please allow enough time to order and receive, the Instructor Manual before the Learner course date. Ideally, the Candidate has an opportunity to read the Instructor Manual prior to the orientation Learner course.

During the registration process, which follows the Learner Course utilized to Orient the Candidate to the teaching process, the Candidate will need to verify that they followed along in a 6th Edition Instructor Manual. Therefore, it is important to notify the Candidate of this requirement so they may order their own Instructor Manual if one is not being provided by the institution. Failure to follow along in an Instructor Manual during the “Orientation to Support” Learner Course presentation will result in denial of the registration form.

STEP 4. The Orientation Full-Length Learner Course and Instructor Team Experience

  1. The Candidate must observe an entire full-length Learner course that is presented by an experienced Registered Lead Instructor or team of experienced, registered Support and Lead Instructors.  
    • “Experienced” is defined as expert neonatal instructors who have taught or participated in teaching at least three S.T.A.B.L.E. Learner courses using the most current version of the program (which is the 6th edition, copyright date 2013).
    • Note: the Candidate is not involved in teaching during the orientation course. However, they should be involved as much as possible with the course logistics, such as setting up the course, preparing for vignette presentation and testing, and setting up the AV equipment.
  2. While the course is in progress, instruct the Candidate to follow along in their instructor manual. Ask them to write down any questions that arise during the presentation.
  3. When the course is finished (or prior to the course beginning), take some time to review with the Candidate the information contained in the Instructor Course Packet and Instructor Course Slide Presentation that you (the Lead Instructor) received at your National or Private S.T.A.B.L.E. Instructor course.
  4. Review your institution’s plan for S.T.A.B.L.E. program implementation as well as any other pertinent items pertaining to the Support instructor’s involvement with the S.T.A.B.L.E. Program.
  5. Once this process has been completed, complete the On-Line Student Roster and mark “Orientation to Support Instructor” when adding the student’s name. To be eligible for Instructor registration, there MUST be a passing pre-test score (70% or higher) and a passing mixed module score (0, 1 or 2 wrong on the first try) as outlined above.
  6. In addition to the standard notification that the roster was approved, you will receive a Support Instructor Registration form.  (See the PDF on this web page for an example of the items that must be verified by both the Candidate and the Lead Instructor responsible for the Candidate’s training process). Upon receipt of this form:
    1. Ask the Candidate to complete their part of the registration form. Be sure the form is legible, and filled out completely, and contains their primary and secondary email address.
    2. The Lead instructor responsible for “training” the Support Instructor must also verify the training process was followed and sign the registration form. Be sure to include the student’s pre-test and mixed module post-test scores. 
  7.  MAIL, SCAN and email, or FAX the registration form to the S.T.A.B.L.E. office with a copy of the Learner Course Roster
  8. When approved by the Roster Administrator, the Support Instructor will receive an email with instructions for logging into the on-line roster and downloading their Instructor card.
  9. If S.T.A.B.L.E. Roster Administrator determines that there is an issue with the Support Instructor’s candidacy, the submitting Lead instructor will be notified.  S.T.A.B.L.E. reserves the right to determine whether a Learner course completion card is more appropriate for the Candidate.

For any questions, please contact The S.T.A.B.L.E. Program Administration staff: Mason Meinhold or Beth St. Thomas at 1-435-655-8171.