Neonatal resuscitation experience curves: simulation based mastery learning booster sessions and skill decay patterns among pediatric residents
-
Heideh H. Matterson
Abstract
Background
Following neonatal resuscitation program (NRP) training, decay in clinical skills can occur. Simulation-based deliberate practice (SBDP) has been shown to maintain NRP skills to a variable extent. Our study objectives were (a) to determine whether a single 30 min simulation-based intervention that incorporates SBDP and mastery learning (ML) can effectively restore skills and prevent skill decay and (b) to compare different timing options.
Methods
Following NRP certification, pediatric residents were randomly assigned to receive a video-recorded baseline assessment plus SBDP-ML refresher education at between 6 and 9 months (early) or between 9 and 12 months (late). One year following initial certification, participants had repeat skill retention videotaped evaluations. Participants were scored by blinded NRP instructors using validated criteria scoring tools and assigned a global performance rating score (GRS).
Results
Twenty-seven participants were included. Residents in both early and late groups showed significant skill decay 7 and 10 months after initial NRP. SBDP-ML booster sessions significantly improved participants’ immediate NRP performance scores (p<0.001), which persisted for 2 months, but were again lower 4 months later.
Conclusions
NRP skills may be boosted to mastery levels after a short SBDP-ML intervention and do not appear to significantly decline after 2 months. Brief booster training could potentially serve as a useful supplement to traditional NRP training for pediatric residents.
Acknowledgment
We would like to thank all of the New York University Langone Medical Center residents who participated in this study and all of the staff at the New York Simulation Center for the Health Sciences (NYSIM) where the study took place.
Author’s statement
Conflict of interest: None of the authors has a conflict of interest to report pertaining to this manuscript. Funding for this study was provided for by the NYU School of Medicine Division of Neonatology Stefan Bennett Fellowship Research Fund.
Material and methods: Informed consent: Informed consent has been obtained from all individuals included in this study.
Ethical approval: The research related to human subject use has complied with all the relevant national regulations, and institutional policies, and is in accordance with the tenets of the Helsinki Declaration, and has been approved by the authors’ institutional review board or equivalent committee.
References
[1] Neonatal Resuscitation Program website. Available at: https://www.aap.org/en-us/continuing-medical-education/life-support/NRP/Pages/History.aspx. Accessed 7 July 2017.Search in Google Scholar
[2] Ergenekon E, Koc E, Atalay Y, Soysal O. Neonatal resuscitation course experience in Turkey. Resuscitation. 2000;45:225–7.10.1016/S0300-9572(00)00179-9Search in Google Scholar
[3] Skidmore M, Urquhart H. Retention of skills in neonatal resuscitation. Paediatr Child Health 2001;6:31–5.10.1093/pch/6.1.31Search in Google Scholar PubMed PubMed Central
[4] Levitt C, Kaczorowski J, Outerbridge E, Jimenez V, Connolly B, Slapcoff B. Knowledge gained following neonatal resuscitation program courses. Fam Med. 1996;28:403–6.Search in Google Scholar
[5] Kaczorowski J, Levitt C, Hammond M, Outerbridge E, Grad R, Rothman A, et al. Retention of neonatal resuscitation skills and knowledge: a randomized controlled trial. Fam Med. 1998;30:705–11.Search in Google Scholar
[6] Patel J, Posencheng M, Ades A. Proficiency and retention of neonatal resuscitation skills by pediatric residents. Pediatrics 2012;130:515–21.10.1542/peds.2012-0149Search in Google Scholar PubMed
[7] Fossel M, Kiskaddon RT, Sternbach GL. Retention of cardiopulmonary resuscitation skills by medical students. Med Educ. 1983;58:568–75.10.1097/00001888-198307000-00007Search in Google Scholar PubMed
[8] Kaye W, Mancini M. Retention of cardiopulmonary resuscitation skills by physicians, registered nurses, and the general public. Crit Care Med. 1986;14:620–2.10.1097/00003246-198607000-00007Search in Google Scholar PubMed
[9] Sawyer T, Sierocka-Castaneda A, Chan D, Berg B, Lustik M, Thompson M. Deliberate practice using simulation improves neonatal resuscitation performance. Simul Healthc. 2011;6:327–36.10.1097/SIH.0b013e31822b1307Search in Google Scholar PubMed
[10] Cordero L, Hart BJ, Hardin R, Mahan JD, Nankervis CA. Deliberate practice improves pediatric residents’ skills and team behaviors during simulated neonatal resuscitation. Clin Pediatr. 2013;52:747–52.10.1177/0009922813488646Search in Google Scholar PubMed
[11] Ericsson KA, Krampe RT, Tesch-Romer C. The role of deliberate practice in the acquisition of expert performance. Psychol Rev. 1993;100:363–406.10.1037/0033-295X.100.3.363Search in Google Scholar
[12] Ericsson KA. Deliberate practice and the acquisition and maintenance of expert performance in medicine and related domains. Acad Med. 2004;79:S70–80.10.1097/00001888-200410001-00022Search in Google Scholar PubMed
[13] Ericsson KA. Deliberate practice and acquisition of expert performance: a general overview. Acad Emerg Med. 2008;15:988–94.10.1111/j.1553-2712.2008.00227.xSearch in Google Scholar PubMed
[14] Bloom BS. An introduction to mastery learning theory. New York: Holt, Rinehart & Winston Publishers; 1971, p. 3–14.Search in Google Scholar
[15] Kattwinkel J, editor. NRP neonatal resuscitation textbook. 6th ed. (English version). Washington, DC: American Academy of Pediatrics; 2011.Search in Google Scholar
[16] Ilgen JS, Ma IW, Hatala R, Cook DA. A systematic review of validity evidence of checklists versus global rating scales in simulation-based assessment. Med Educ. 2015;49:161–73.10.1111/medu.12621Search in Google Scholar PubMed
[17] Pusic MV, Kessler D, Szyld D, Kalet A, Pecaric M, Boutis K. Experience curves as an organizing framework for deliberate practice in emergency medicine learning. Acad Emerg Med. 2012:19:1476–80.10.1111/acem.12043Search in Google Scholar PubMed
[18] Wood AM, Jones MD Jr, Wood JH, Pan Z, Parker TA. Neonatal resuscitation skills among pediatricians and family physicians: is residency training preparing for post residency practice? J Grad Med Educ. 2011;3:475–80.10.4300/JGME-D-10-00234.1Search in Google Scholar PubMed PubMed Central
[19] Carbine DN, Finer NN, Knodel E, Rich W. Video recording as a means of evaluating neonatal resuscitation performance. Pediatrics 2000;106:654–8.10.1542/peds.106.4.654Search in Google Scholar PubMed
[20] O’Donnell CP, Kamlin CO, Davis PG, Morley CJ. Endotracheal intubation attempts during neonatal resuscitation: success, rates, duration, and adverse effects. Pediatrics 2006;117:e17–21.10.1542/peds.2005-0901Search in Google Scholar PubMed
[21] Block JH, editor. Mastery learning: theory and practice. New York: Holt, Rinehart and Winston; 1971.Search in Google Scholar
[22] McGaghie WC, Miller GE, Sajid A, Telder TV. Competency based curriculum development in medical education. Public Health Paper No. 68. Geneva Switzerland: World Health Organization; 1978.Search in Google Scholar
[23] Wayne DB, Siddall VJ, Butter J, Fudala MJ, Wade LD, Feinglass J, et al. A longitudinal study of internal medicine residents’ retention of advanced cardiac life support skills. Acad Med. 2006; 81(10 Suppl):S9–12.10.1097/00001888-200610001-00004Search in Google Scholar PubMed
Article note
This article was selected from submitted papers on the occasion of the 40th Annual Scientific Meeting of The New York Perinatal Society, held on April 25, 2017.
©2018 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Frontmatter
- Editorial
- What’s new in the multiple gestations literature?
- Corner of Academy
- Is pravastatin a milestone in the prevention and treatment of preeclampsia?
- Research articles – Obstetrics
- Ultrasound study of fetal movements in singleton and twin pregnancies at 12–19 weeks
- Association of histological chorioamnionitis and magnesium sulfate treatment in singleton and dichorionic twin pregnancies with preterm premature rupture of membranes: preliminary observations
- Outcomes of physical examination-indicated cerclage in twin pregnancies with acute cervical insufficiency compared to singleton pregnancies
- First trimester β-hCG and estradiol levels in singleton and twin pregnancies after assisted reproduction
- Does ultrasound-guided intervention during repeat cesarean sections improve uterine scar architecture and reduce the number of scars? A prospective controlled clinical intervention trial
- Effects of tributyltin on placental cytokine production
- Does rescue cerclage work?
- Computerized prediction system for the route of delivery (vaginal birth versus cesarean section)
- Anencephaly and obstetric outcome beyond the age of viability
- Somatic development at birth as influenced by maternal characteristics – an analysis of the German Perinatal Survey
- Thromboprophylaxis in pregnant women with thrombophilia and a history of thrombosis
- Research articles – Fetus
- Adrenal gland size in growth restricted fetuses
- Research articles – Newborn
- Effect of pre-pregnancy body mass index on respiratory-related neonatal outcomes in women undergoing elective cesarean prior to 39 weeks
- Growth and body composition in preterm newborns with bronchopulmonary dysplasia: a cohort study
- Utility of serum resistin in the diagnosis of neonatal sepsis and prediction of disease severity in term and late preterm infants
- Incidence of early-onset sepsis in infants born to women with clinical chorioamnionitis
- Neonatal resuscitation experience curves: simulation based mastery learning booster sessions and skill decay patterns among pediatric residents
- Serum biomarkers of neuronal injury in newborns evaluated for selective head cooling: a comparative pilot study
- Short communication
- Outcomes in oligohydramnios: the role of etiology in predicting pulmonary morbidity/mortality
Articles in the same Issue
- Frontmatter
- Editorial
- What’s new in the multiple gestations literature?
- Corner of Academy
- Is pravastatin a milestone in the prevention and treatment of preeclampsia?
- Research articles – Obstetrics
- Ultrasound study of fetal movements in singleton and twin pregnancies at 12–19 weeks
- Association of histological chorioamnionitis and magnesium sulfate treatment in singleton and dichorionic twin pregnancies with preterm premature rupture of membranes: preliminary observations
- Outcomes of physical examination-indicated cerclage in twin pregnancies with acute cervical insufficiency compared to singleton pregnancies
- First trimester β-hCG and estradiol levels in singleton and twin pregnancies after assisted reproduction
- Does ultrasound-guided intervention during repeat cesarean sections improve uterine scar architecture and reduce the number of scars? A prospective controlled clinical intervention trial
- Effects of tributyltin on placental cytokine production
- Does rescue cerclage work?
- Computerized prediction system for the route of delivery (vaginal birth versus cesarean section)
- Anencephaly and obstetric outcome beyond the age of viability
- Somatic development at birth as influenced by maternal characteristics – an analysis of the German Perinatal Survey
- Thromboprophylaxis in pregnant women with thrombophilia and a history of thrombosis
- Research articles – Fetus
- Adrenal gland size in growth restricted fetuses
- Research articles – Newborn
- Effect of pre-pregnancy body mass index on respiratory-related neonatal outcomes in women undergoing elective cesarean prior to 39 weeks
- Growth and body composition in preterm newborns with bronchopulmonary dysplasia: a cohort study
- Utility of serum resistin in the diagnosis of neonatal sepsis and prediction of disease severity in term and late preterm infants
- Incidence of early-onset sepsis in infants born to women with clinical chorioamnionitis
- Neonatal resuscitation experience curves: simulation based mastery learning booster sessions and skill decay patterns among pediatric residents
- Serum biomarkers of neuronal injury in newborns evaluated for selective head cooling: a comparative pilot study
- Short communication
- Outcomes in oligohydramnios: the role of etiology in predicting pulmonary morbidity/mortality
