一种可定制的新生儿复苏数字认知辅助工具：基于模拟的随机对照试验。

A Customizable Digital Cognitive Aid for Neonatal Resuscitation: A Simulation-Based Randomized Controlled Trial.

机构信息

From the Women, Mother and Children Hospital (L.B., M.B., A.B.), Departement of Neonatology, Claude Bernard University of Lyon, Bron, France; The Center for Teaching by Simulation in Health Care (B.B., A.B.), SAMSEI, Lyon, France; The Normandie Simulation Center in Health Care (NorSimS) (M.R., B.G.), Division of Neonatology, Department of Pediatrics, Caen Normandie University, Caen, France (M.R., B.G.); Fleyriat Hospital, Department of Pediatrics, Division of Pediatric Medecine, Bourg en Bresse, France (S.L.); Pierre Wertheimer Hospital, Department of Anesthesia, Intensive Care Unit, Bron, France (B.B.); and Croix-Rousse University Hospital, Department of Neonatology, Lyon, France (G.P.).

出版信息

Simul Healthc. 2024 Oct 1;19(5):302-308. doi: 10.1097/SIH.0000000000000790. Epub 2024 Apr 8.

DOI:10.1097/SIH.0000000000000790

PMID:38587329

Abstract

OBJECTIVE

Adherence to the International Liaison Committee on Resuscitation (ILCOR) algorithm optimizes the initial management of critically ill neonates. In this randomized controlled trial, we assessed the impact of a customizable sequential digital cognitive aid (DCA), adapted from the 2020 ILCOR recommendations, compared with a poster cognitive aid (standard of care [SOC]), on technical and nontechnical performance of junior trainees during a simulated critical neonatal event at birth.

METHODS

For this prospective, bicentric video-recorded study, students were recruited on a voluntary basis, and randomized into groups of 3 composed of a pediatric resident and two midwife students. They encountered a simulated cardiac arrest at birth either (1) with DCA use and ILCOR algorithm poster displayed on the wall (intervention group) or (2) with sole ILCOR algorithm poster (poster cognitive aid [SOC]). Technical and nontechnical skills (NTS) between the two groups were assessed using a standardized scoring of videotaped performances. A neonate specific NTS score was created from the adult Team score.

RESULTS

108 students (36 groups of three) attended the study, 20 groups of 3 in the intervention group and 16 groups of 3 in the poster cognitive aid (SOC) group. The intervention group showed a significant improvement in the technical score ( P < 0.001) with an average of 24/27 points (24.0 [23.5-25.0]) versus 20.8/27 (20.8 [19.9-22.5]) in poster cognitive aid (SOC) group. No nontechnical score difference was observed. Feedback on the application was positive.

CONCLUSIONS

During a simulated critical neonatal event, use of a DCA was associated with higher technical scores in junior trainees, compared with the sole use of ILCOR poster algorithm.

摘要

目的

遵循国际复苏联合会（ILCOR）算法可优化危重新生儿的初始管理。在这项随机对照试验中，我们评估了一种可定制的顺序数字认知辅助工具（DCA）的影响，该工具改编自 2020 年 ILCOR 建议，与海报认知辅助工具（标准护理 [SOC]）相比，对初级学员在模拟出生时的危急新生儿事件中的技术和非技术表现的影响。

方法

在这项前瞻性、双中心录像研究中，学生自愿参加，并按 3 人一组的方式随机分为儿科住院医师和两名助产士学生组成的小组。他们要么（1）使用 DCA 和墙上显示的 ILCOR 算法海报（干预组），要么（2）仅使用 ILCOR 算法海报（海报认知辅助工具 [SOC]）遇到模拟的出生时心脏骤停。使用视频记录的表现进行标准化评分来评估两组的技术和非技术技能（NTS）。从成人团队评分中创建了特定于新生儿的 NTS 评分。

结果

共有 108 名学生（36 组 3 人）参加了这项研究，干预组中有 20 组 3 人，海报认知辅助工具（SOC）组中有 16 组 3 人。干预组的技术评分显著提高（P < 0.001），平均得分为 24/27 分（24.0 [23.5-25.0]），而海报认知辅助工具（SOC）组得分为 20.8/27 分（20.8 [19.9-22.5]）。未观察到非技术评分差异。对应用程序的反馈是积极的。