Improvement of Immediate Performance in Neonatal Resuscitation Through Rapid Cycle Deliberate Practice Training

Magee, Maclain J.; Farkouh-Karoleski, Christiana; Rosen, Tove S.

doi:10.4300/jgme-d-17-00467.1

Cited by 53 publications

(72 citation statements)

References 13 publications

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“…The ScopRev [ 1 0 0 7 _ T D $ D I F F ] 14b identified 1 RCT 15 and 3 observational studies of preintervention and postintervention design. 16À 18 One study considered video debriefing, 16 1 considered the use of a checklist combined with video debriefing, 18 and 1 considered the use of a checklist with a team prebrief/debrief as the key element in a quality improvement bundle.…”

Section: Summary Of Evidencementioning

confidence: 99%

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Neonatal Life Support 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations

Wyckoff¹,

Wyllie²,

Aziz³

et al. 2020

Resuscitation

109

114

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This 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With TreatmentRecommendations (CoSTR) for neonatal life support includes evidence from 7 systematic reviews, 3 scoping reviews, and 12 evidence updates.The Neonatal Life Support Task Force generally determined by consensus the type of evidence evaluation to perform; the topics for the evidence updates followed consultation with International Liaison Committee on Resuscitation member resuscitation councils. The 2020 CoSTRs for neonatal life support are published either as new statements or, if appropriate, reiterations of existing statements when the task force found they remained valid.Evidence review topics of particular interest include the use of suction in the presence of both clear and meconium-stained amniotic fluid, sustained inflations for initiation of positive-pressure ventilation, initial oxygen concentrations for initiation of resuscitation in both preterm and term infants, use of epinephrine (adrenaline) when ventilation and compressions fail to stabilize the newborn infant, appropriate routes of drug delivery during resuscitation, and consideration of when it is appropriate to redirect resuscitation efforts after significant efforts have failed.All sections of the Neonatal Resuscitation Algorithm are addressed, from preparation through to postresuscitation care. This document now forms the basis for ongoing evidence evaluation and reevaluation, which will be triggered as further evidence is published.Over 140 million babies are born annually worldwide (https://ourworldindata.org/grapher/births-and-deaths-projected-to-2100). If up to 5% receive positive-pressure ventilation, this evidence evaluation is relevant to more than 7 million newborn infants every year. However, in terms of early care of the newborn infant, some of the topics addressed are relevant to every single baby born.

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Section: Summary Of Evidencementioning

confidence: 99%

“…17 The RCT determined whether there was benefit to rapid cycle deliberate practice compared with standard simulation debriefing. 15 This entire ScopRev [ 1 0 0 8 _ T D $ D I F F ] 14b can be found in Supplement Appendix B-1.…”

Section: Summary Of Evidencementioning

confidence: 99%

Neonatal Life Support 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations

Wyckoff¹,

Wyllie²,

Aziz³

et al. 2020

Resuscitation

109

114

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“…It allows for feedback to be provided and areas for improvement to be identified as mistakes are made, rather than reflectively at the end of the scenario, and allows the level of difficulty to adjust to the competency of the learner. Studies have shown significant improvement in learner skills using RCDP [16, 18, 19]. Traditional simulation debriefing typically occurs at the end of the resuscitation with a longer period of time to reflect on performance and develop plans for modifications to use during subsequent resuscitations [20].…”

Section: Introductionmentioning

confidence: 99%

Rapid cycle deliberate practice vs. traditional simulation in a resource-limited setting

et al. 2019

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Background We sought to develop a low-fidelity simulation-based curriculum for pediatric residents in Rwanda utilizing either rapid cycle deliberate practice (RCDP) or traditional debriefing, and to determine whether RCDP leads to greater improvement in simulation-based performance and in resident confidence compared with traditional debriefing. Methods Pediatric residents at the Centre Hospitalier Universitaire de Kigali (CHUK) were randomly assigned to RCDP or traditional simulation and completed a 6 month-long simulation-based curriculum designed to improve pediatric resuscitation skills. Pre- and post- performance was assessed using a modified version of the Simulation Team Assessment Tool (STAT). Each video-taped simulation was reviewed by two investigators and inter-rater reliability was assessed. Self-confidence in resuscitation, pre- and post-simulation, was assessed by Likert scale survey. Analyses were conducted using parametric and non-parametric testing, ANCOVA and intra-class correlation coefficients (ICC). Results There was a 21% increase in pre- to post-test performance in both groups ( p < 0.001), but no difference between groups (mean difference − 0.003%; p 0.94). Inter-rater reliability was exceptional with both pre and post ICCs ≥0.95 (p < 0.001). Overall, self-confidence scores improved from pre to post (24.0 vs. 30.0 respectively, p < 0.001), however, the there was no difference between the RCDP and traditional groups. Conclusions Completion of a six-month low-fidelity simulation-based curriculum for pediatric residents in Rwanda led to statistically significant improvement in performance on a simulated resuscitation. RCDP and traditional low-fidelity simulation-based instruction may both be valuable tools to improve resuscitation skills in pediatric residents in resource-limited settings. Electronic supplementary material The online version of this article (10.1186/s12909-019-1742-4) contains supplementary material, which is available to authorized users.

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“…Rapid Cycle Deliberate Practice (RCDP) as a method of within-event debriefing has been shown to improve pediatric resident resuscitation [5]. It has also been shown to be an effective teaching method for neonatal resuscitation training [6]. When using RCDP, we allow learners multiple opportunities to “do it right” while giving them direct feedback until they master the skill [5].…”

Section: Introductionmentioning

confidence: 99%

Rapid Cycle Deliberate Practice (RCDP) as a Method to Improve Airway Management Skills – A Randomized Controlled Simulation Study

Gross¹,

Abrahan²,

Kumar³

et al. 2019

Cureus

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Background: Paediatric intubations are a relatively rare but critical procedure that requires adequate practice to achieve skillful performance. Simulation is a method to teach intubation skills in a safe environment. Rapid Cycle Deliberate Practice (RCDP), as a method of simulation debriefing, has been shown to improve pediatric resident resuscitation skills. It has not been demonstrated if RCDP can be effectively used in procedural skills training. The objective of this study was to determine if RCDP with feedback in real-time, as well as an opportunity to repeat the action, is superior to a simulation where no feedback is provided during the simulation and is instead provided after the simulation. Materials and Methods: This was a randomized controlled single-blinded study. All participants were videotaped during a simulated pre-assessment intubation, then received either the intervention (RCDP) or the control teaching (feedback after the simulation), followed by a post-assessment intubation. These videos were scored by two independent raters on an intubation checklist. The primary outcome was the change in score. The secondary outcome was intubation success. Results: Thirty-five students met the inclusion criteria. The RCDP group achieved a significantly higher score improvement in the preparation and post-procedure care categories. The overall score change in the RCDP group was significantly higher than in the control group, with a mean difference of -11.86 (CI -15.57 to -8.15, p<0.00001), but there was no significant improvement in intubation success. Conclusion: Our study suggests that RCDP is an effective method to teach the procedural skill of intubation with an emphasis on procedural choreography. RCDP could be an appropriate method for debriefing learners in procedural skills training in this population.

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Improvement of Immediate Performance in Neonatal Resuscitation Through Rapid Cycle Deliberate Practice Training

Abstract: Immediately following RCDP interns had improved observed abilities and decreased time to perform critical interventions in NR simulation as compared to those trained with the simulation debriefing. RCDP was not superior in improving confidence level or retention.

Cited by 53 publications

References 13 publications

Neonatal Life Support 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations

Neonatal Life Support 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations

Rapid cycle deliberate practice vs. traditional simulation in a resource-limited setting

Rapid Cycle Deliberate Practice (RCDP) as a Method to Improve Airway Management Skills – A Randomized Controlled Simulation Study

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