Simulation-Based Summative Assessment of Neonatal Resuscitation Providers Using the RETAIN Serious Board Game—A Pilot Study

Abstract

Background: Each year, 13-26 million newborn babies require help to breathe at birth. Healthcare professionals (HCPs) who provide neonatal resuscitative care must be frequently evaluated to maintain and improve the quality of healthcare delivered. While simulation-based competence assessment is preferred, resource constraints hinder uptake. We aimed to examine if the RETAIN simulation-based boardgame can be used to assess HCPs' neonatal resuscitation knowledge.Method: Twenty neonatal HCPs (19 females) from the Royal Alexandra Hospital (Edmonton, Canada) were recruited. First, they completed an open-answer written test of one neonatal resuscitation scenario. Then, they completed one neonatal resuscitation scenario of difficulty comparable to that of the open-answer written test, but this time using the RETAIN board game. In the RETAIN board game (https://playretain.com, RETAIN Labs Medical Inc, Edmonton, Canada), players perform simulated neonatal resuscitation scenarios based on real-life cases, using action cards, and equipment pieces. Sessions were video-recorded and scored using Neonatal Resuscitation Program 2015 guidelines. Data are reported as mean (standard deviation) for normally distributed continuous variables, and as median (interquartile range) for non-normal continuous variables.Results: Participants consisted of the following HCPs: 8 nurses, 4 respiratory therapists, 4 nurse practitioners, and 4 neonatal fellows with median (IQR) 10.5(3-17) years of clinical experience. Overall mean (SD) Open-answer test and Game Performance was 8.6(2.1) out of 16 possible points (53%) and 29(3.2) out of 40 possible points (74%), respectively. Out of the 10 actions shared between the open-answer test and game scenario, performance on the open-answer test was mean (SD) 7.2(1.3) (72%) and game performance was mean (SD) 8.8(1.4) (88%) (V = 17, p < 0.01). Ghoman et al.Summative Assessment Using a Board Game Conclusion: RETAIN may provide an enjoyable and standardized alternative toward summative assessment of neonatal resuscitation providers. RETAIN may be used to improve more frequent and ubiquitous uptake of simulation-based competence assessment in healthcare settings.

Digital Simulation Improves, Maintains, and Helps Transfer Health-Care Providers' Neonatal Resuscitation Knowledge

“…RETAIN (REsuscitation TrAINing; RETAIN Labs Medical Inc. Edmonton, Canada; https://www.retainlabsmedical.com/index.html ) is a digital simulator for HCPs to practice their knowledge and decision-making of neonatal resuscitation ( 9 – 12 ). In RETAIN, users are presented with scenarios of varying difficulty and medical conditions.…”

“…In the table-top simulator, players use action cards (e.g., initiate positive pressure ventilation), equipment pieces (e.g., T-piece mask), and adjustable monitors (e.g., increase peak inspiratory pressure), to stabilize a low-fidelity simulated newborn infant presented on a 2D board. More information about the table-top simulator is presented in the literature ( 6 , 9 , 11 ). The action cards are identical to the action buttons presented in the digital simulator.…”

“…In contrast, the pre-test, post-test, 2-month post-test , and 5-month post-test were assessment scenarios. The RETAIN table-top simulation was previously reported as a method for summative assessment of neonatal resuscitation providers ( 9 ).…”

Using the RETAIN Tabletop Simulator as a Summative Assessment Tool for Neonatal Resuscitation Healthcare Professionals: A Pilot Study

“…The RETAIN tabletop simulator (RETAIN Labs Medical Inc. Edmonton, Canada; https://www.retainlabsmedical.com) was developed for HCPs to practice their knowledge of the neonatal resuscitation algorithm, communication, and teamwork (12)(13)(14)(15)(16). The game board consists of an image of a newborn infant, equipment pieces (e.g., radiant warmer), and reference tables (i.e., MR SOPA) ( Figure 1A).…”

“…RETAIN contains over 50 neonatal resuscitation scenarios, based on real cases from the Royal Alexandra Hospital (Edmonton, Canada) delivery room. Further information about RETAIN and gameplay can be found in the literature (12)(13)(14)(15)(16)(17)(18).…”