Original Publication
Open Access

Newborn Nursery Teaching Attending Guide: Module 4. Newborn Ballard Exam

Published: September 10, 2012 | 10.15766/mep_2374-8265.9231

Included in this publication:

  • Newborn Ballard Exam Facilitator's Guide.docx
  • Newborn Exam Ballard.mov
  • Newborn Nursery Ballard Exam Checklist.pdf

To view all publication components, extract (i.e., unzip) them from the downloaded .zip file.

Editor's Note: This publication predates our implementation of the Educational Summary Report in 2016 and thus displays a different format than newer publications.


This resource is a part of a seven-module curriculum intended to provide teaching faculty caring for well newborns with accessible, approachable, easily delivered, hands-on tools for bedside teaching in the newborn nursery. The seven modules are linked. This module focuses on the demonstration of the Ballard Exam. The template for a Ballard examination is frequently not incorporated into electronic health records and is consequently not being performed as frequently and systematically at our institutions. Medical student, residents, and nursing students have less familiarity with the components of a Ballard examination and are less likely to be able to systematically assess infant gestational age in the absence of formal introduction to the topic. The video was produced as an educational tool by the authors and is used in nursing and physician education at our institutions. The checklist was added and modeled after a newborn physical examination checklist created for our medical students and residents. The checklist was trialed at University of Michigan and Oregon Health & Science University where it has been incorporated as a standard in resident education. Students found the video particularly helpful. The examination can be difficult for first time learners, in particular the neuromuscular maturity portion. Early learners may focus on the physical maturity portion. The video also allows for an opportunity to discuss hand hygiene in patient care. Hand hygiene is of critical importance in the care of all patients, but especially when caring for newborns.

Educational Objectives

By the end of the module, the learner will be able to:

  1. Understand the components of a thorough and appropriate Ballard examination.
  2. Understand the importance of assessing an infant’s gestational age.

Author Information

  • Jocelyn Schiller, MD: University of Michigan Medical School
  • Katherine Layton, MD: Peninsula Regional Medical Center
  • John Westfall: University of Michigan
  • Chris Chapman: University of Michigan
  • Carrie Phillipi: Oregon Health and Science University

None to report.

None to report.


  1. Ballard JL, Khoury JC, Wedig K, et al: New Ballard Score, expanded to include extremely premature infants. J Pediatrics 1991; 119:417-423. http://dx.doi.org/10.1016/S0022-3476(05)82056-6
  2. Dubowitz LM, Dubowitz V, Palmer P, Verghote M. A new approach to the neurological assessment of the preterm and fullterm newborn infant. Brain Dev. 1980;2(1):3–14. http://dx.doi.org/10.1016/S0387-7604(80)80003-9
  3. http://www.ballardscore.com/ (accessed 8-14-12).


Schiller J, Layton K, Westfall J, Chapman C, Phillipi C. Newborn nursery teaching attending guide: module 4. Newborn ballard exam. MedEdPORTAL. 2012;8:9231. https://doi.org/10.15766/mep_2374-8265.9231