Educational Strategies for Maintaining Technical Skills in Neonatal Resuscitation for the Nursing Team: A Pilot Project
Educational Strategies for Maintaining Technical Skills in Neonatal Resuscitation for the Nursing Team: A Pilot Project
Despite efforts for initial training in neonatal resuscitation, health professionals show a decline in post-training skills, requiring continuing training. This randomized controlled pilot study will compare the feasibility and preliminary effects of two educational tools in the field, namely the traditional teaching method (instructor-assisted deliberate practice) and an educational tool developed during the research project that involves repeated peer-guided practice. Both groups will perform the same educational activity using a mobile training station equipped with the equipment necessary for the PPV. Each session will be of 30 minutes and will be repeated three times over a period of three months.
Background :
Despite efforts for initial training in neonatal resuscitation (NR), health professionals show a decline in post-training skills, requiring continuing training. Lack of practice, financial resources and competent worker are the main challenges encountered on the department. However, optimal care in NR, particularly in positive pressure ventilation (PPV) saves lives. Deliberate practice (DP) is a simulation-based instructional strategy known for its effectiveness in maintaining skills. However, DP is limited by the resources and costs linked to the presence of experts. Self-directed, learner-centred approaches could solve these challenges.
This pilot study seeks to compare the proposed tool with a traditional method which is learning through PD guided by an instructor. This feasibility study will make it possible in the future to plan more in-depth research to promote the possibility of generalization.
Th specific research objectives are as follows.
Methods
Convenience sampling due to its pragmatic approach. It allows to recruit accessible participants on time and with limited resources. A stratified randomization will be used to optimize the balance of the groups taking into account the two types of professionals (registered nurses and practical nurses).
The aim is to recruit 50 participants, in order to reach a sample of 40 participants in total considering a potential loss to follow-up of 15%.
Educational activities:
The content of the educational activity focuses on maintaining technical skills in positive pressure ventilation (PPV) during neonatal resuscitation and will be based on the contents of the chapter "Positive pressure ventilation" of the "Neonatal resuscitation manual, 8th edition". This activity consists of putting into practice the actions leading to the VPP sequence, as described in the road map, using the T-piece resuscitation machine (Neopuff) and the self-inflating bag, both of which are available in the clinic. It will take place on a mobile training station equipped with the necessary equipment for VPP. Each session will last 30 minutes and will be held during the participants' work shift, thus benefiting from protected time for training, and will be repeated three times over a three-month period.
The teaching strategy varies between the two groups of participants, which are:
Demographic and professional questionnaire:
Following consent to participate in the project, participants will have to complete this questionnaire including demographic data, including age by interval and gender, as well as professional data including work shift (day, evening, night, day and night rotation), initial training (college, university, other), the number of months of experience in neonatology, the approximate number of neonatal resuscitations and positive pressure ventilation in which they participated, the approximate number of simulations in neonatal intensive care in which they participated. These data will be used to describe the characteristics of the study sample.
Performance test (before and after training):
To assess changes in technical skills following the intervention, each participant will be assessed before and after the training.
The assessment will be carried out in the simulation room in the neonatal unit and will last 5 minutes. Upon arrival, the participant will be presented with a clinical vignette of a patient requiring positive pressure ventilation (see appendix). This vignette was created by the project researchers based on their experience in the field of neonatology. After two minutes of positive pressure ventilation, the patient will be stabilized and the vignette will end. A short feedback will be provided to the participant after the evaluation.
Two evaluators, including possibly the researcher himself, will complete the evaluation of each video recording, being blind to the participant's group as well as the phase of the study (pre or post training), using the tool "Neonatal Mask Ventilation Competency Assessment Tool". The effectiveness and relevance of this tool in the evaluation of essential clinical skills has been demonstrated, thus justifying its adoption for the project.
Final questionnaire:
This questionnaire will be completed by the participants at the end of their last practical session and is made up of a first part dedicated to the Continuing Professional Development (CPD) questionnaire and a second which assesses the degree of satisfaction, confidence and feasibility of the tool educational. This data will allow evaluation of th feasibility component, confidence as well as the propensity to change one's practice following th intervention.
Inclusion Criteria:
Exclusion Criteria: