From the Allan Waters Family Simulation Centre, Li Ka Shing Knowledge Institute (D.M.C.), St. Michael's Hospital; Division of Neonatology, Department of Pediatrics, University of Toronto (N.H.C., D.M.C.); Department of Pediatrics, St. Michael's Hospital (N.M., D.M.C.); and Division of Paediatric Medicine (N.M.), The Hospital for Sick Children, Toronto, ON, Canada.
Simul Healthc. 2019 Jun;14(3):146-156. doi: 10.1097/SIH.0000000000000353.
Despite standardized neonatal resuscitation program (NRP) training, retention and adherence to the NRP algorithm remain a challenge. Cognitive aids can potentially improve acquisition and application of NRP knowledge and skills. The objective of this study was to determine whether an interactive mobile application providing audiovisual prompts, NRP Prompt, can help novice NRP providers learn the NRP algorithm more effectively and therefore improve their NRP performance.
First- and second-year residents from family medicine and obstetrics and gynecology attending NRP training were randomized into intervention and control groups. Resident pairs used standard visual aids with NRP Prompt (intervention) or visual aids only (control) in two simulated neonatal resuscitation training sessions with each resident taking turns as a team leader. Pairs were then evaluated in a third simulation that was video recorded, where neither group used cognitive aids. The primary outcome was comparing resuscitation performance. Secondary outcomes included the following: times to positive-pressure ventilation, intubation, and chest compressions.
Thirty-nine residents participated, of which 18 received the intervention. Neonatal resuscitation program performance scores did not significantly differ (P = 0.69). Wilcoxon rank-sum tests showed no significant differences in secondary outcomes of times to positive-pressure ventilation (P = 0.43), intubation (P = 0.44), or chest compressions (P = 0.35).
Training using NRP Prompt did not improve performance scores in simulated neonatal resuscitations immediately after training. Potential reasons include voice prompts in their current format being distracting and lack of customizability to user preferences. Future development of prompting applications should apply a user-centered design approach to optimize the ability to meet end-user needs.
尽管有标准化的新生儿复苏方案（NRP）培训，但保留和遵守 NRP 算法仍然是一个挑战。认知辅助工具可以潜在地提高 NRP 知识和技能的获取和应用。本研究的目的是确定提供视听提示的交互式移动应用程序（NRP Prompt）是否可以帮助新手 NRP 提供者更有效地学习 NRP 算法，从而提高他们的 NRP 表现。
参加 NRP 培训的家庭医学和妇产科的一年级和二年级住院医师被随机分为干预组和对照组。在两次模拟新生儿复苏培训中，住院医师配对使用标准视觉辅助工具和 NRP Prompt（干预组）或仅使用视觉辅助工具（对照组），每个住院医师轮流担任团队负责人。然后，在第三个模拟中对他们进行评估，该模拟进行了录像，两个组都不使用认知辅助工具。主要结果是比较复苏表现。次要结果包括以下内容：正压通气、插管和胸外按压的时间。
共有 39 名住院医师参与，其中 18 名接受了干预。新生儿复苏方案表现评分没有显著差异（P = 0.69）。Wilcoxon 秩和检验显示，正压通气（P = 0.43）、插管（P = 0.44）或胸外按压（P = 0.35）的次要结果时间无显著差异。
在培训后立即进行的模拟新生儿复苏中，使用 NRP Prompt 进行培训并未提高表现评分。潜在原因包括当前格式的语音提示分散注意力，以及缺乏对用户偏好的可定制性。未来的提示应用程序开发应采用以用户为中心的设计方法，以优化满足最终用户需求的能力。
