NEST Program

Neonatal Education and Simulation-Based Training Program


To improve neonatal outcomes through technology-enhanced training and simulation research.


To provide global leadership in neonatal education, simulation-based training, and scholarship.

Specific Aims

  • Improve neonatal outcomes through individual and interprofessional education
  • Leverage emerging technologies for simulation-based training and research 
  • Define optimal processes for neonatal resuscitation
  • Investigate methods to enhance the acquisition and retention of technical and behavioral skills
  • Promote educational scholarship in the next generation of neonatal care providers

Current Projects

  • Regional boot camps for neonatal-perinatal fellows
  • National neonatology fellows curriculum
  • Neonatal resuscitation training
  • Neonatal procedural skills training
  • Team training to optimize neonatal care 
  • Virtual simulation training with augmented and mixed reality
  • Teleneonatology/Telesimulation
  • Disaster simulations
  • Outreach education to support regional neonatal care

NEST Program Faculty:

Rachel Umoren, MBBCh, MS
Director of NEST Program
Director for Immersive Learning & Telesimulation

Megan Gray, MD
Director for Research and Curriculum Development

Tom Strandjord, MD
Director of Clinical Integration

Taylor Sawyer DO, MEd
Director of Outreach Education

Zeenia Billimoria, MD
Director of ECMO and Transport Simulation

Sarah Handley, MD
Associate Director of Outreach Education

Christine Cooper, DNP, MBA
Associate Director of Clinical Integration

Nathan Schooley, ARNP, NNP-BC
Associate Director of Telesimulation



NEST Program Fellows

Brianna Brei, MD
Neonatology Fellow (Class of 2020)

Patrick Motz, DO, MPH
Neonatology Fellow (2016-2019)

Jeanne Krick, MD
Neonatology Fellow (2015-2018)

Chapters/Textbooks/Other Publications

Sawyer T. Lead Instructor. Neonatal Resuscitation Program (NRP) Instructor Course Learning Activity (online). Neonatal Resuscitation Program. American Academy of Pediatrics. 2016.

Johnston L, Auerbach M, Nagler J, Nishisaki A, Sawyer T, White M, Wolbrink T. Neonatal Tracheal Intubation. 11/2016. Online video. OPENPediatrics.

Umoren RA, Rybas N. Who am I as a healthcare provider? Identity and transformative learning in virtual environments in Stricker A, Calongne C,  Truman B,  Arenas F (Eds). Integrating an awareness of selfhood and society into virtual learning. A volume in the Advances in Educational Technologies and Instructional Design (AETID) Book Series. Hershey: IGI Global. 2017 Jan 5:166.

Cheng A, Eppich W, Sawyer TL, Grant V. Debriefing: The state of the art and science in healthcare simulation. In: Healthcare Simulation Education: Evidence, Theory and Practice. Hoboken NJ: WileyBlackwell; 2017: In press

Parker T, Chess P, Rice W, Reber K, Sawyer T. Neonatology Entrustable Professional Activities Curricular Components. In: Carraccio C, Woods S, eds. Neonatal-Perinatal Medicine Entrustable Professional Activities. 1st Ed. Chapel Hill, NC. The American Board of Pediatrics; 2018: 34-53.

Sawyer T, Ali N. Resuscitation of the Newborn. In: Gomella T, ed. Neonatology: Management, Procedures, on-Call Problems, Diseases, and Drugs. 8th Ed. Stamford, Conn: Appleton & Lange; 2019: In press

Sawyer T, Gray M, Umoren R. Umbilical line placement. In: Soghier L, Robin B, eds. Neonatal Simulation Guidebook. Chicago, IL: American Academy of Pediatrics; 2019: In press.

Sawyer T, Gray M, Umoren R. Manikins and Task Trainers. In: Soghier L, Robin B, eds. Neonatal Simulation Guidebook. Chicago, IL: American Academy of Pediatrics; 2019: In press.

Umoren RA, Thomas P. Immersive Learning: Virtual and Augmented Reality. In: Soghier L, Robin B, eds. Neonatal Simulation Guidebook. Chicago, IL: American Academy of Pediatrics; 2019: In press.

Umoren RA, Truman B. Transdisciplinary Collaborative Development of Healthcare Virtual Simulations in Stricker A, Calongne C, Truman B, Arenas F (Eds). Recent Advances in Applying Identity and Society Awareness to Virtual Learning. A volume in the Advances in Educational Technologies and Instructional Design (AETID) Book Series. Hershey: IGI Global; 2019: In press.

Ades A, Sawyer T, Halamek L. Improving Neonatal Care. In: Deutsch E, Perry S, Gurnanay, eds. Comprehensive Healthcare Simulation: Improving Healthcare Systems. New York, NY. Springer Publishing; 2019: In press.

Sawyer T, Gray M. Debriefing ECMO simulation: Special Considerations. In Johnston L and Su L, eds. ECMO Simulation - A Theoretical and Practical Guide. New York, NY. Springer Publishing; 2019: In press.


  • National Institute of Health (2017-2020)
  • Bill & Melinda Gates Foundation (2017-2020)
  • Coulter Foundation (2015-2019)
  • Microsoft MR Academic Seeding Program (2018)
  • Simio Academic Software Institution Grant (2018-2020)
  • National Science Foundation I-Corps Grant (2017)
  • UW Center for Leadership and Innovation in Medical Education (2017-2019)
  • UW Patient Safety Innovations Program (2017-2018)
  • Seattle Children’s Academic Enrichment Fund (2016-2019)
  • University of Washington CoMotion Innovation Fund (2016-2018)
  • UW Neonatal Bioresearch Fund (2014-2019)


Neonatal Education and Training Courses Offered by the NEST Program:

For more information on the NEST Program please send us an email:


NEST Program Publications (2015-2019)

Braun L, Sawyer T, Smith K, Hsu A, Behrens M, Chan D, Hutchinson J, Lu D, Singh R, Reyes J, Lopreiato J. Retention of Pediatric Resuscitation Performance After a Simulation-Based Mastery Learning Session: A Multicenter Randomized Trial. Pediatr Crit Care Med. 2015 Feb;16(2):131-138. PMID: 25647122

Sawyer T, White M, Zaveri P, Chang T, Ades A, French H, Anderson J, Auerbach M, Johnston L, Kessler D. “Learn, See, Practice, Prove, Do, Maintain”: An Evidence-based Pedagogical Framework for Procedural Skill Training in Medicine. Acad Med. 2015. Aug;90(8):1025-33. PMID: 25881645

Lopreiato J, Sawyer T. Simulation-based Medical Education in Pediatrics. Acad Pediatr. 2015 Mar-Apr;15(2):134-42. PMID: 25748973

Sawyer T, Strandjord T, Johnson K, Low D. Neonatal Airway Simulators, How Good Are They? A Comparative Study of Physical and Functional Fidelity. J Perinatol. 2016 Feb;36(2):151-6.

West C, Graham L, Palmer RT, Miller MF, Thayer EK, Stuber ML, Awdishu, L, Umoren RA, Wamsley MA, Nelson EA, Joo PA, Tysinger JW, George P, Carney PA on behalf of NIH R25 Social and Behavioral Science Consortium Interprofessional Education Workgroup. Implementation of Interprofessional Education (IPE) in 16 U.S. Medical Schools: Common Practices, Barriers and Facilitators. Journal of Interprofessional Education & Practice 4 (2016) 41-49.

Ishizuka M, Rangarajan V, Sawyer TL, Napolitano N, Boyer DL, Morrison WE, Lockman JL, Berg RA, Nadkarni VM, Nishisaki A. The development of tracheal intubation proficiency outside the operating suite during pediatric critical care medicine fellowship training: a retrospective cohort study using cumulative sum analysis. Pediatr Crit Care Med. 2016. PMID: 27214591

Sawyer T, Fu B, Gray M, Umoren RA. Medical improvisation training to enhance the antenatal counseling skills of neonatologists and neonatal fellows: a pilot study. The Journal of Maternal-Fetal & Neonatal Medicine (2016)1-5. PMID:27549009.

Gray MM, T Sawyer. Procedural Training and Assessment of Competency Utilizing Simulation. Seminars in Perinatology. 2016 Nov;40(7):438-446. PMID: 27692475.

Sawyer TL, Loren DJ, Halamek LP. Post-event debriefings during neonatal care: why are we not doing them, and how can we start? J Perinatol. 2016 Jun;36(6):415-9. PMID: 27031321

Sawyer TL, Eppich W, Brett-Fleegler M, Grant V, Cheng A. More Than One Way to Debrief: A Critical Review of Healthcare Simulation Debriefing Methods. Simul Healthc. 2016 Jun;11(3):209-17. PMID: 27254527

Sawyer TL, French H, Ades A, Johnston L. Neonatal-perinatal medicine fellow procedural experience and competency determination: Results of a national survey. J Perinatol. 2016 Jul;36(7):570-4. PMID: 26938919

Ishizuka M, Rangarajan V, Sawyer TL, Napolitano N, Boyer D, Morrison W, Lockman J, Berg R, Nadkarni V, Nishisaki A. The development of tracheal intubation proficiency outside the operating suite during pediatric critical care medicine fellowship training: A retrospective cohort study using cumulative sum analysis. Pediatr Crit Care Med. 2016 Jul;17(7):e309-16. PMID: 27214591

Sawyer TL, Ades A, Ernst K, Colby C. Simulation and the neonatal resuscitation program 7th edition curriculum. NeoReviews. 2016 Aug;17(8):e447-e453. DOI: 10.1542/neo.17-8-e447.

Sawyer TL, Starr M, Jones M, Hendrickson M, Bosque E, McPhillips H, Batra M. Real versus simulated umbilical cords for emergency umbilical catheterization training: A randomized crossover study. J Perinatol. 2016 Oct 27. PMID: 27787505.

Ali N, Sawyer TL, Barry J, Grover T, Ades A. Resuscitation practices for infants in the NICU, PICU and CICU: Results of a national survey. J Perinatol. 2016 Oct 27. PMID: 27787506.

Sawyer T, Umoren RA, Gray MM. Neonatal resuscitation: Advances in training and practice. Advances in Medical Education and Practice. 2017;8:11-19. PMID: 28096704.

Gray MM, Delaney H, Umoren RA, Strandjord T, Sawyer T. Accuracy of the nasal-tragus length Measurement for correct endotracheal tube placement in a cohort of neonatal resuscitation simulators. Journal of Perinatology. 2017 May 4. PMID: 28471440

Sawyer T, Foglia E, Hatch D, Moussa A, Ades A, Johnston L, Nishisaki A. Improving neonatal intubation safety: A journey of a thousand miles. J Neonatal Perinatal Med. 2017; 10(2):125-131 PMID28409758

Umoren RA, Poore JA, Sweigart L, Rybas N, Gossett E, Johnson M, Allen M, Scott PJ, Truman B, Das R. TeamSTEPPS virtual teams: Interactive virtual team training and practice for health professional learners. Creative Nursing: A Journal of Values, Issues, Experience, and Collaboration. 2017:23(3).

Starr M, Sawyer T, Jones M, Batra M, McPhillips H. A simulation-based quality improvement approach to improve pediatric resident competency with required procedures. Cureus. 2017;9(6): e1307. DOI 10.7759/cureus.1307

Davidson L, Utarnachitt R, Mason A, Sawyer T. Development and testing of a neonatal intubation checklist for an air medical transport team. Air Medical Journal. 2017. DOI: 10.1016/j.amj.2017.09.010

Umoren RA, Scott PJ, Sweigart L, Gossett E, Hodson-Carlton K, Johnson M, Jones JA, Poore JA, Rybas N, Truman B, Das R. A Comparison of Teamwork Attitude Changes with Virtual TeamSTEPPS Simulations in Health Professional Students. Journal of Interprofessional Education and Practice. 2018;10:51-55.

Davidson L, Utarnachitt R, Mason A, Sawyer T. Development and testing of a neonatal intubation checklist for an air medical transport team. Air Med J. 2018 Jan - Feb;37(1):41-45. PMID: 29332775.

Motz P, Umoren R, Maicher K, Danforth D, Kett J, Gray M, Sawyer T. Virtual antenatal encounter and standardized simulation assessment (VANESSA): A pilot study. JMIR Serious Games. 2018 May;6(2):e8. PMID: 29752249.

Sawyer T, Nishisaki A. Intraosseous access during newborn resuscitation: It may be fast, but is it safe? Pediatr Crit Care Med. 2018 May;19(5):499-501. PMID: 29727423.

Krick J, Gray M, Umoren R, Lee G, Sawyer T. Premedication with paralysis improves intubation success and decreases adverse events in very low birth weight infants: A prospective cohort study. J Perinatol. 2018 Jun;38(6):681-686. PMID: 29467520.

Umoren R, Gray M, Schooley N, Billimoria Z, Smith K, Sawyer T. Effect of telemedicine on transport management of simulated neonatal patients. Air Med J. 2018 Sep;37(5):317-320. PMID: 30322635.

French H, Gray MM, Gilliam-Krakauer M, Bonachea EM, Carbajal M, Payne A, Vasquez M, Rubinos L, Falck A, Izatt S, Dadiz R. Flipping the classroom: a national pilot curriculum for physiology in neonatal-perinatal medicine. J Perinatol, 2018 Oct;38(10):1420-1427. PMID 30087455

Chabra S, Sawyer T. Ten commandments for neonatal-perinatal medicine fellows. J Med Educ Curric Dev. 2018 Sep;19;5:1-3. PMID: 30263968.

Sawyer T, Gray M. Simulation-based procedural skill training. IMR. 2018 Sep. DOI: 10.18103/imr.v4i9.760.

Gray M, Umoren R, Strandjord T, Sawyer T. Use and perceived safety of stylets for neonatal endotracheal intubation: A national survey. J Perinatology. 2018 Oct;38(10):1331-1336 PMID: 30093617.

Sawyer T, Lee H, Aziz K. Anticipation and preparation for every delivery room resuscitation. Semin Fetal Neonatal Med. 2018 Oct;23(5):312-320. PMID: 30369405.

Sawyer T, Anderson M. Healthcare Simulation research in Simulation & Gaming: past, present, and future. Simulation & Gaming. 2018 Oct. 49(5) 475–478. DOI: 10.1177/1046878118803686.

Sawyer T, Gray M, Hendrickson M, Jacobson E, Umoren R. A real human umbilical cord simulator model for emergency umbilical venous catheter placement training. Cureus. 2018 Nov 5;10(11):e3544. PMID: 30450269.

Foglia E, Ades A, Sawyer T, Glass K, Singh N, Jung P, Quek BH, Johnston L, Barry J, Zenge J, Moussa A, Kim J, DeMeo S, Napolitano N, Nadkarni V, Nishisaki A, for the NEAR4NEOS Investigators. Neonatal intubation practice and outcomes: An international registry study. Pediatrics. 2019 Jan;143(1). pii: e20180902. PMID: 30538147.

Chabra S, Sawyer T, Strand M. The meconium aspirator: still a useful tool during newborn resuscitation. Am J Perinatol. 2019 Jan. doi: 10.1055/s-0038-1677477. [Epub ahead of print]. PMID: 30646418.

Wong J, Manhas D, Campbell DM, Moussa A, Sawyer T. Procedural experience of Canadian neonatal-perinatal medicine fellows. J Clin Neonatol. 2019 Jan;8:47-53. DOI: 10.4103/jcn.JCN_110_18.

Sawyer T, Burke C, McMullan M , Yalon L, Valdivia H, Chan T, Roberts J. Impacts of a pediatric extracorporeal cardiopulmonary resuscitation (ECPR) simulation training program. Acad Pediatr. 2019 Jan 23. pii: S1876-2859(19)30008-7. [Epub ahead of print]. PMID: 30684655.

Sawyer T, Rovera E J. Publication Activity and Impact of the International Pediatric Simulation Society Cureus Channel: 2014 to 2018. Cureus. 2019;11(2): e4067. DOI 10.7759/cureus.4067. PMID: 31016094.

Johnston L, Sawyer T, Nishisaki A, Whtifill T, Ades A, French H, Glass K, Dadiz R, Bruno C, Levit O, Gangadharan S, Zhong J, Scherzer D, Arnold J, Stavroudis T, Auerbach M. Neonatal intubation competency assessment tool: Development and validation. Acad Pediatr. 2019 Mar;19(2):157-164. PMID: 30103050.

Brady J, Kovatis K, O’dea CL, Gray MM, Ades A. A Qualitative Analysis: What do neonatal-perinatal fellows identify as critical for achieving competency in tracheal intubation? Neonatology. 2019 Mar 19;116(1):10-16. PMID: 30889585.

Izatt S, Gray M, Dadiz R, French H. Development and implementation of a national neonatology flipped classroom curriculum. Journal of Graduate Medical Education. 2019 June;11(3):335-336. PMID: 31210868.

Sawyer T, Foglia E, Ades A, Moussa A, Napolitano N, Glass K, Johnston L, Jung P, Singh N, Quek BH, Barry J, Zenge J, DeMeo SD, Kim J, Nadkarni V, Nishisaki A. Incidence, impact, and indicators of difficult intubations in the NICU. Arch Dis Child Fetal Neonatal Ed. 2019 Feb 22. pii: fetalneonatal-2018-316336. [Epub ahead of print]. PMID: 30796059.

Kumar D, Vachharajani AJ, Wertheimer F, Vergales B, Glass K, Dannaway D, Winter L, Delaney H,  Ganster A, Arnold J, Urban A, Johnston L, Bruno C, Gray MM, Sawyer T. Boot camps in neonatal-perinatal medicine fellowship programs: a national survey. J Neonatal Perinatal Med. Feb.2019;12(2):231-237. PMID: 30829620.

Sawyer T, Motz P, Schooley N, Umoren R. Positive pressure ventilation coaching during neonatal bag-mask ventilation: A simulation-based pilot study. J Neonatal Perinatal Med. 2019 Mar 20. doi: 10.3233/NPM-1618119. PMID: 30909252.

Sawyer T, Foglia E. Resuscitation Quality Metrics for the Newly Born. Am J Perinatol. 2019 Mar 1. doi: 10.1055/s-0039-1681098. PMID: 30822798.

Ozawa Y, Ades A, Foglia E, DeMeo S, Barry J, Sawyer T, Singh N, Glass K, Jung P, Huey Quek B,  Johnston L, Kim J, Napolitano N, Shults J, Nadkarni V, Nishisaki A. Premedication with paralysis during neonatal intubation is associated with fewer adverse events. J Perinatol. 2019 Apr 2. doi: 10.1038/s41372-019-0367-0. PMID: 30940929.

Sawyer T, Billimoria Z, Handley S, Smith K, Yalon L, Brogan TV, DiGeronimo R. Therapeutic plasma exchange for neonatal septic shock: A retrospective cohort study. Am J Perinatol. 2019 Jun 8. doi: 10.1055/s-0039-1692184. PMID: 31176309.

Sawyer, T., Foglia, E., Ades, A., Moussa, A., Napolitano, N., Glass, K., Johnston, L., Jung, P., Singh, N., Quek, BH., Barry, J., Zenge, J., DeMeo, S., Brei, B., Krick, J., Kim, J., Nadkarni, V., Nishisaki, A., for the National Emergency Airway Registry for Neonates (NEAR4NEOS) investigators. Incidence, impact, and indicators of difficult intubations in the neonatal intensive care unit: A Report from the National Emergency Airway Registry for Neonates. Archives of Disease in Childhood-Fetal and Neonatal Edition. Published online first: 22 February 2019. DOI: 10.1136/archdischild-2018-316336.

Billimoria Z, Chabra A, Patel A, Gray M, Umoren R, Sawyer T. Apgar Score of 0 at 10 Minutes and Survival to One Year of Age: A Retrospective Cohort Study in Washington State. J Perinatol. 2019. In press.

Dines JN, Sawyer T, Neufeld-Kaiser W, Disteche CM, Liu YJ, Dipple K. Expanding phenotype with severe midline brain anomalies and missense variant supports a causal role for FOXA2 in 20p11.2 deletion syndrome. Am J Med Genet. 2019. In press.

Sawyer T, Stavroudis TA, Ades A, Dadiz R, Dammann CEL, Halamek LP, Moussa A, Soghier L, Gupta A, Aliaga S, Umoren R, French H. Simulation in Neonatal-Perinatal Medicine Fellowship Programs. Am J Perinatol. 2019. In press. 

Umoren R, Sawyer T, Ades A, DeMeo SD, Foglia E, Glass K, Gray M, Barry J, Johnston L, Jung P, Kim J, Krick J, Moussa A, Mulvey C, Nadkarni V, Napolitano N, Quek BH, Singh N, Zenge J, Shults J, Nishisaki A. Team stress and adverse events during neonatal tracheal intubations: a report from NEAR4NEOS. Am J Perinatol. 2019. In press. 

Gray MM, Thomas A, Umoren RA. Identifying Crucial Equipment and Skills Needed to Evacuate Critically Ill Infants During Disasters: Using Nursing Expertise to Guide Training Targets. Journal of Prehospital and Disaster Medicine. In press.