Characterization of teamwork and guideline compliance in prehospital neonatal resuscitation simulations

Bahr, Nathan; Huynh, Trang; Lambert, William E.; Guise, Jeanne Marie

doi:10.1016/j.resplu.2022.100248

Cited by 2 publications

(3 citation statements)

References 26 publications

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“…Previous studies have identified practice deviation from NRP guidelines by prehospital providers, especially with regard to drying, warming, stimulating, and suctioning the baby [ 20 ]. These practice deviations are not only frequent, but also have the potential for mild and even severe harm [ 21 ]. Similar deviations were identified during our study, which also included a high incidence of chest compressions performed when they should not have been.…”

Section: Discussionmentioning

confidence: 99%

Use of a SimBox, a Video-Augmented, Newborn Resuscitation Simulation for Prehospital Providers to Measure Clinical Performance and Educational Experience

Athanasopoulou,

Cicero,

Sanseau

et al. 2024

Cureus

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Objectives: Few studies have described the current clinical practices, adherence to guidelines, and outcomes of newborn resuscitations attended by emergency medical services (EMS). SimBox, a novel, video-augmented simulation, was used to describe the adherence of prehospital providers to Neonatal Resuscitation Program guidelines, to measure satisfaction with the simulation intervention, and to describe the self-reported improvement in knowledge, skills, and attitudes after the simulation. Methods: A prospective observational cohort study of EMS providers was designed and conducted using SimBox, an open-access simulation platform, and facilitated by EMS educators. Clinical performance measures were collected using a five-item checklist. Simulation satisfaction measures were collected through net promoter scores. Learners’ demographics, and self-reported knowledge, skills, and attitudes were measured using a retrospective survey of 25 questions. Results: In total, 33 facilitator and 55 learner surveys were collected across Connecticut, Colorado, and Alaska between July 2021 and September 2022. At least one deviation from clinical guidelines occurred in 22/30 (73.3%) of the sessions, with 10/30 (33.3%) teams inappropriately performing chest compressions, 5/31 (16.1%) teams not warming, drying, stimulating, and suctioning the newborn, and 7/31 (22.6%) teams not performing positive pressure ventilation correctly. Lastly, 10/30 (33.3%) teams administered an incorrect dose of dextrose-containing fluids. Very high levels of satisfaction were reported with net promoter scores of 97 and 82 out of 100 for the facilitator and learner surveys, respectively. Finally, all 55/55 (100%) of the learners strongly or somewhat agreed that the simulation improved their knowledge, teamwork, communication, and psychomotor skills. Conclusions: In this cohort of prehospital providers, clinical management decisions during a newborn resuscitation simulation often deviated from the gold-standard, newborn resuscitation guidelines. Free, online, open-access simulation resources like SimBox can be used to identify and measure practice deviations from standardized resuscitation protocols in the prehospital setting.

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Section: Discussionmentioning

confidence: 99%

Use of a SimBox, a Video-Augmented, Newborn Resuscitation Simulation for Prehospital Providers to Measure Clinical Performance and Educational Experience

Athanasopoulou,

Cicero,

Sanseau

et al. 2024

Cureus

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“…On the other hand, in recent years, the methods of optimal management of newborns have gradually changed towards non-invasive methods [ 6 ]. All these reasons prevent the acquisition and retention of skills [ 3 , 27 ]. The results of the research have shown patterns of skill decline in pediatric residents.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, well-trained neonatal resuscitation providers must be available if such measures are needed [ 1 ]. Neonatal resuscitation program (NRP) guidelines have been developed by the American Academy of Pediatrics (AAP), International Liaison Committee on Pediatrics (ILCOR), and American Heart Association(AHA) to provide life-saving care to improve birth outcomes when emergencies occur [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Enhancing residents’ neonatal resuscitation competency through team-based simulation training: an intervention educational study

Farhadi,

Azandehi,

Amuei

et al. 2023

BMC Med Educ

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Background Neonatal resuscitation training in a simulated delivery room environment is a new paradigm in pediatric medical education. The purpose of this research is to highlight team-based simulation as an effective method of teaching neonatal resuscitation to senior pediatric residents. Methods In an intervention educational study, we evaluated the impact of team-based simulation training in the development of neonatal resuscitation. A team consisting of a three-person group of senior pediatric residents performed neonatal resuscitation on a low-fidelity newborn simulator based on the stated scenario. Video-based structured debriefing was performed and followed by the second cycle of scenario and debriefing to evaluate the feasibility of conducting team-based simulation training in a lesser-resourced environment. Evaluation criteria included megacode scores which is a simulation performance checklist, pre-and post-test scores to evaluate residents’ knowledge and confidence, the survey checklist as a previously developed questionnaire assessing residents’ satisfaction, and debriefing from live and videotaped performances. Four months after the end of the training course, we measured the behavioral changes of the residents by conducting an OSCE test to evaluate post-training knowledge retention. Mean ± SD was calculated for megacode, satisfaction (survey checklist), and OSCE scores. Pre- and post-program gains were statistically compared. The first three levels of Kirkpatrick’s training effectiveness model were used to evaluate the progress of the program. Results Twenty-one senior residents participated in the team-based simulation. The mean ± SD of the megacode score was 35.6 ± 2.2. The mean ± SD of the overall satisfaction score for the evaluation of the first level of the Kirkpatrick model was 96.3 ± 3.7. For the evaluation of the second level of the Kirkpatrick model, the pre-posttest gain in overall confidence score had a statistically significant difference (P = 0.001). All residents obtained a passing grade in OSCE as an evaluation of the third level. Conclusions Team-based simulation training in neonatal resuscitation improves the knowledge, skills, and performance of pediatric residents and has a positive effect on their self-confidence and leadership skills. There is still a need to investigate the transfer of learning and abilities to real-life practice, and further research on cost-effectiveness and impact on patient outcomes is warranted.

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Characterization of teamwork and guideline compliance in prehospital neonatal resuscitation simulations

Cited by 2 publications

References 26 publications

Use of a SimBox, a Video-Augmented, Newborn Resuscitation Simulation for Prehospital Providers to Measure Clinical Performance and Educational Experience

Use of a SimBox, a Video-Augmented, Newborn Resuscitation Simulation for Prehospital Providers to Measure Clinical Performance and Educational Experience

Enhancing residents’ neonatal resuscitation competency through team-based simulation training: an intervention educational study

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