From the Department of Pediatrics (L.T.D., M.A.U., K.R.H.), University of California, Davis, Sacramento, CA.
Simul Healthc. 2020 Dec;15(6):377-381. doi: 10.1097/SIH.0000000000000446.
Because improved competence in caring for patients is difficult to measure, self-efficacy (the strength of one's belief in one's ability to complete a task) is often used as a surrogate measurement of clinical ability. However, studies in adults and children have shown at best only weak correlations between self-efficacy and performance. This correlation has not been well studied in neonatal resuscitation limiting the utility of self-efficacy as a measurement of the effectiveness of interventions in this population. The objective of this study was to determine whether self-efficacy correlates with performance of simulated neonatal chest compressions and ventilation.
Sixty-nine neonatal fellows, neonatal nurse practitioners, neonatologists, and nurses completed a 7-point Likert scale in which they reported their ability to perform ventilations and chest compressions. The participants then performed chest compressions and bag-valve-mask ventilation on a mannequin. The performance of participants was compared with the rating of their ability using Spearman rank correlation coefficient.
There was no correlation between participants' self-assessment and performance of chest compressions (rs = 0.003) or bag-valve-mask ventilation (rs = 0.08). There was a correlation between experience (years of neonatal intensive care unit experience, number of mock codes, and number of real codes) and the ratings of self-efficacy as well as between the number of mock codes and ventilation performance.
In this study, self-reported efficacy had no correlation to clinical skills in neonatal resuscitation; participants both overestimated and underestimated their clinical proficiency. Prior participation in mock codes in the neonatal intensive care unit was the only factor that correlated with resuscitation performance.
由于难以衡量患者护理能力的提高，自我效能感（对自己完成任务能力的信心强度）通常被用作临床能力的替代衡量标准。然而，成人和儿童的研究表明，自我效能感与表现之间的相关性充其量只有微弱的相关性。在新生儿复苏中，这种相关性尚未得到很好的研究，限制了自我效能感作为衡量干预措施在该人群中有效性的衡量标准的应用。本研究的目的是确定自我效能感是否与模拟新生儿胸外按压和通气的表现相关。
69 名新生儿研究员、新生儿执业护士、新生儿科医生和护士完成了 7 点李克特量表，报告他们进行通气和胸外按压的能力。然后，参与者在模型上进行胸外按压和球囊面罩通气。使用 Spearman 等级相关系数比较参与者的表现与能力评估之间的相关性。
参与者的自我评估与胸外按压（rs=0.003）或球囊面罩通气（rs=0.08）的表现之间没有相关性。经验（新生儿重症监护病房经验年限、模拟代码数量和实际代码数量）与自我效能感评估之间存在相关性，模拟代码数量与通气性能之间也存在相关性。
在这项研究中，自我报告的功效与新生儿复苏的临床技能没有相关性；参与者高估和低估了他们的临床熟练程度。之前在新生儿重症监护病房参与模拟代码是与复苏表现相关的唯一因素。
