Health Care Providers’ Performance, Mindset, and Attitudes Toward a Neonatal Resuscitation Computer-Based Simulator: Empirical Study

Abstract

Background Neonatal resuscitation involves a complex sequence of actions to establish an infant’s cardiorespiratory function at birth. Many of these responses, which identify the best action sequence in each situation, are taught as part of the recurrent Neonatal Resuscitation Program training, but they have a low incidence in practice, which leaves health care providers (HCPs) less prepared to respond appropriately and efficiently when they do occur. Computer-based simulators are increasingly used to complement traditional training in medical education, especially in the COVID-19 pandemic era of mass transition to digital education. However, it is not known how learners’ attitudes toward computer-based learning and assessment environments influence their performance. Objective This study explores the relation between HCPs’ attitudes toward a computer-based simulator and their performance in the computer-based simulator, RETAIN (REsuscitation TrAINing), to uncover the predictors of performance in computer-based simulation environments for neonatal resuscitation. Methods Participants were 50 neonatal HCPs (45 females, 4 males, 1 not reported; 16 respiratory therapists, 33 registered nurses and nurse practitioners, and 1 physician) affiliated with a large university hospital. Participants completed a demographic presurvey before playing the game and an attitudinal postsurvey after completing the RETAIN game. Participants’ survey responses were collected to measure attitudes toward the computer-based simulator, among other factors. Knowledge on neonatal resuscitation was assessed in each round of the game through increasingly difficult neonatal resuscitation scenarios. This study investigated the moderating role of mindset on the association between the perceived benefits of understanding the terminology used in the computer-based simulator, RETAIN, and their performance on the neonatal resuscitation tasks covered by RETAIN. Results The results revealed that mindset moderated the relation between participants’ perceived terminology used in RETAIN and their actual performance in the game (F3,44=4.56, R2=0.24, adjusted R2=0.19; P=.007; estimate=–1.19, SE=0.38, t44=–3.12, 95% CI –1.96 to –0.42; P=.003). Specifically, participants who perceived the terminology useful also performed better but only when endorsing more of a growth mindset; they also performed worse when endorsing more of a fixed mindset. Most participants reported that they enjoyed playing the game. The more the HCPs agreed that the terminology in the tutorial and in the game was accessible, the better they performed in the game, but only when they reported endorsing a growth mindset exceeding the average mindset of all the participants (F3,44=6.31, R2=0.30, adjusted R2=0.25; P=.001; estimate=–1.21, SE=0.38, t44=−3.16, 95% CI –1.99 to –0.44; P=.003). Conclusions Mindset moderates the strength of the relationship between HCPs’ perception of the role that the terminology employed in a game simulator has on their performance and their actual performance in a computer-based simulator designed for neonatal resuscitation training. Implications of this research include the design and development of interactive learning environments that can support HCPs in performing better on neonatal resuscitation tasks.

Improving Pediatric/Neonatology Residents' Newborn Resuscitation Skills With a Digital Serious Game: DIANA

“…The administration of a user satisfaction questionnaire confirmed a greater appreciation for DGBL as a training methodology than the classic frontal theory teaching session, in line with the existing literature (13,19,20). DGBL methodology usability is crucial for future developments, as learners positively disposed to digital tools tend to respond more effectively (26). Based on the satisfaction questionnaire results, appreciation was lower for the check equipment game compared to the others, despite its effectiveness on improving user scoring.…”

“…Furthermore, in DGBL group, user improvement was evaluated as the sessions progressed by recording any change in individual tests' numerical values (equipment score, procedure score, response time, ventilation frequency, compression rate) as common in DGBL methodologies (26). At the end of data collection, a user satisfaction questionnaire was administered to DGBL group, to integrate subsequent versions of the software with user suggestions.…”

“…We will also seek to modify the software with/without hardware integration to widen the potential user base, including other clinical specialties and varying levels of experience. In particular, we aim to extend this learning tool to users less accustomed to digital technology to further assess the impact of user mindset on the effectiveness of DGBL methodology (26). Moreover, as DGBL is unlikely to be adopted as a stand-alone teaching method (11) [especially in higher education (14)], future research may involve using the two methods in sequence, e.g., reinforcing the classic theory teaching session by DGBL, or a simulator-based introduction to a classic teaching session.…”

A Computer-Based Interactive Narrative and a Serious Game for Children With Asthma: Development and Content Validity Analysis

“…Point rewards and badges as part of gamification are essential for attracting children’s attention [ 43 ]. A previous study that applied a computer-based neonatal resuscitation training game for nursing students consisted of scenarios with an increasingly difficult neonatal resuscitation activity in each round [ 44 ]; it was designed to promote a growth mindset in terms of attitudes and performance. Provision of feedback and challenges in developing a growth mindset are meaningful and relevant to users.…”

The Effects of a Digital Game Simulator versus a Traditional Intervention on Paramedics’ Neonatal Resuscitation Performance

“…Thus, we developed the RETAIN (REsuscitation TrAINing) digital game [9,10] as an online simulator that mimics the real-life neonatal scenarios occurring in a delivery room to provide HCPs with training opportunities that are more accessible to them at any day and time, without having to make an appointment for in-person training or refresher sessions.…”