McGlinn Leigh A, Sundgren Nathan C
Neonatology, Texas Children's Hospital, Houston, USA.
Cureus. 2022 Oct 24;14(10):e30632. doi: 10.7759/cureus.30632. eCollection 2022 Oct.
The Neonatal Resuscitation Program (NRP) is a national education program that prepares learners to resuscitate newborn babies. Our local Texas Children's Hospital (TCH) NRP educational class incorporates skills training and high-fidelity simulations of neonatal resuscitation scenarios. The skills training had four elements we believed were not ideal. 1. Learners went to skills stations in groups, but different teams were formed for performing the scenario simulations in the latter half of the class. 2. The skills stations were visited in random order and not necessarily the actual order in the skills would be performed in a clinical situation. 3. Educational content presented at the skills station was highly variable depending on the instructor. 4. Emphasis was on instructors teaching content over learners practicing and demonstrating skills. In March 2019 we restructured the skills education portion completely to address all four of these problems.
To determine how changes to the design of our skills education affected learner satisfaction with the NRP course.
Using the principles of situated cognition, the skills education was restructured by leadership planning and consensus. We made four changes. 1. Teams were assigned from the beginning of class, and these teams practiced all skills and performed the simulations together. 2. Every team went through the skills stations in the order they would perform them in an actual resuscitation. 3. Videos were made to teach the "gold standard" information needed for the skills stations. 4. Instructors were asked to think of themselves as coaches and not teachers, letting the videos do the education, and they focused on improving skill performance. A survey was designed and disseminated by e-mail to all learners of the first 13 classes taught using the new educational format (n=196). The survey asked learners to compare their experience of the new format compared to their memory of the previous format.
A total of 163 learners responded and completely finished the survey (83% response rate). Of the 163 respondents, 109 learners (67%) had taken the course in the past at TCH and filled out the survey questions comparing the new format to the past format. Out of the total, 93% of learners (n=101) judged the new format to be "better" or "much better." The percentage of learners that attributed the improvement to the changes we made were: 70% for team assignments from the beginning (n=76), 74% for skills performed in order (n=81), 68% for video-based education (n=74), and 76% for instructors as coaches (n=83). Learners rated the videos used for education very highly.
The reformat of our skills education has improved our learners' experience during NRP training. The highest-rated change was asking our instructors to operate as coaches rather than teachers.
新生儿复苏项目（NRP）是一项全国性教育项目，旨在让学习者掌握新生儿复苏技能。我们当地的德克萨斯儿童医院（TCH）NRP教育课程包括技能培训和新生儿复苏场景的高仿真模拟。我们认为技能培训有四个方面不理想。1. 学习者分组前往技能站，但在课程后半段进行场景模拟时会重新组队。2. 技能站的参观顺序是随机的，不一定是临床实际操作中的顺序。3. 技能站所呈现的教育内容因指导教师而异。4. 重点是指导教师讲授内容，而不是学习者练习和展示技能。2019年3月，我们对技能教育部分进行了全面重组，以解决所有这四个问题。
确定技能教育设计的改变如何影响学习者对NRP课程的满意度。
运用情境认知原则，通过领导规划和达成共识对技能教育进行重组。我们做了四项改变。1. 从课程开始就分配团队，这些团队一起练习所有技能并进行模拟。2. 每个团队按照实际复苏中的操作顺序依次通过各个技能站。3. 制作视频来教授技能站所需的“金标准”信息。4. 要求指导教师将自己视为教练而非教师，让视频进行教学，他们则专注于提高技能表现。设计了一项调查问卷，并通过电子邮件分发给使用新教育模式授课的前13个班级的所有学习者（n = 196）。该调查要求学习者将他们对新形式的体验与之前形式的记忆进行比较。
共有163名学习者回复并完整完成了调查（回复率为83%）。在163名受访者中，109名学习者（67%）过去曾在TCH参加过该课程，并填写了将新形式与过去形式进行比较的调查问卷问题。总体而言，93%的学习者（n = 101）认为新形式“更好”或“好得多”。将改进归因于我们所做改变的学习者比例分别为：从课程开始就分配团队占70%（n = 76），按顺序进行技能操作占74%（n = 81），基于视频的教育占68%（n = 74），指导教师担任教练占76%（n = 83）。学习者对用于教育的视频评价很高。
我们技能教育的重新设计改善了学习者在NRP培训期间的体验。评价最高的改变是要求我们的指导教师担任教练而非教师。
