ALERT Presentation:Improving neonatal resuscitationusing a virtual interactive trainer Judy LeFlore, JoDee Anderson, Myra Wyckoff, Taylor Sawyer, Lindsay Johnston, Susan Niermeyer, Akira Nishisaki, Kathleen Ventre, Marge Zielke
Background• Airway management continues to be the leading challenge to neonatal patient survival and safety because endotracheal intubation skills are not easily taught.• Proficiency in safe and successful endotracheal tube placement improves with experience• Inability to recognize key landmarks for successful endotracheal intubation is the most significant failure point.• There is evidence that gaming and virtual reality in health care education increases knowledge acquisition and facilitates skill acquisition and transfer to clinical practice.
PICO Question• Population – Healthcare providers that have newborn resuscitation opportunities • NNPs • Pediatric residents • Respiratory therapists • Paramedics• Intervention – Neonatal Interactive Virtual Airway Trainer (NIVAT)• Comparison – Power point presentation• Outcome – Intubation success in the clinical setting will be greater for the NIVAT intervention group than for the PP intervention group
Approach• 3-Phase study (Design over 3 years) 1. Phase I: Development Phase 1. Develop NIVAT, Proficiency assessment, PPT 2. Rater reliability 3. Recruit/randomize 1. Benchmark proficiency (#1) 2. Orient to intervention, study protocol, introduce journals 4. Participants keep journals during remainder of Dev Phase 2. Phase 2: Intervention Phase 1. Collect journals (#1) 2. Proficiency assessment (#2) 3. Intervention 3. Phase 3: Degradation Phase 1. Collect journals (#2) 2. Proficiency assessment (#3) 3. Data analysis
Develop Phase (1 year) Intervention Phase Begins1. NIVAT 1. Collect journals (#1)2. PPT 2. Proficiency assessment (#2)3. Proficiency assessment tool 3. NIVAT or PPT Group Intervention4..Recruit5. Randomize6. Rater reliability Decay Phase7. Benchmark Proficiency (#1), 1. Collect journals (#2)8.Orient to intervention, study 2. Proficiency assessment (#3)protocol, and journal. 3. Data analysis9 Study participants keepjournals during DevelopmentPhase
3 Questions• HOW DO WE: – To calculate adequately power for the study, what should be used to calculate effect size? – 30second from AAP – Success on first or second try 80% of time? – Where to recruit from now the GME no longer requires intubation as a competency. Will program directors think this study is important? How do we promote participants adherence to monthly NIVAT or PPT. Should we try different exposure times to assess “Dose effect”? Reliability of keeping accurate journals r/t intubation opportunities throughout the study? – Recruit research assistants committed to completing proficiency assessments when indicated