Teamwork and Adherence to Guideline on Newborn Resuscitation—Video Review of Neonatal Interdisciplinary Teams

Brogaard, Lise; Hvidman, Lone; Esberg, Gitte; Finer, Neil N.; Hjorth-Hansen, Kristiane R.; Manser, Tanja; Kierkegaard, Ole; Uldbjerg, Niels; Henriksen, Tine Brink

doi:10.3389/fped.2022.828297

Cited by 13 publications

(6 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This calls for rethinking our learning path for vacuum extraction, ensuring that trainees learn to include effective teamwork behavior in training and practice. Thus, this study confirms the results on surgical (30), trauma (31,32), and resuscitation teams (33)(34)(35) regarding the importance of non-technical skills in providing high clinical performance. Clinical performance and non-technical skills.…”

Section: Discussionsupporting

confidence: 86%

Team performance during vacuum-assisted vaginal delivery: video review of obstetric multidisciplinary teams

Brogaard,

Rosvig,

Hjorth-Hansen

et al. 2024

Front. Med.

View full text Add to dashboard Cite

IntroductionVacuum extraction is generally considered an operator-dependent task, with most attention directed toward the obstetrician’s technical abilities (1–3). Little is known about the effect of the team and non-technical skills on clinical outcomes in vacuum-assisted delivery. This study aimed to investigate whether the non-technical skills of obstetricians were correlated with their level of clinical performance via the analysis of video recordings of teams conducting actual vacuum extractions.MethodsWe installed between two or three video cameras in each delivery room at Aarhus University Hospital and Horsens Regional Hospital and obtained 60 videos of teams managing vacuum extraction. Appropriate consent was obtained. Two raters carefully reviewed the videos and assessed the teams’ non-technical skills using the Assessment of Obstetric Team Performance (AOTP) checklist, rating all items on a Likert scale score from 1 to 5 (1 = poor; 3 = average; and 5 = excellent). This resulted in a total score ranging from 18 to 90. Two different raters independently assessed the teams’ clinical performance (adherence to clinical guidelines) using the TeamOBS-Vacuum-Assisted Delivery (VAD) checklist, rating each item (0 = not done, 1 = done incorrectly; and 2 = done correctly). This resulted in a total score with the following ranges (low clinical performance: 0–59; average: 60–84; and high: 85–100). Interrater agreement was analyzed using intraclass correlation (ICC), and the risk of high or low clinical performance was analyzed on a logit scale to meet the assumption of normality.ResultsTeams that received excellent non-technical scores had an 81% probability of achieving high clinical performance, whereas this probability was only 12% among teams with average non-technical scores (p < 0.001). Teams with a high clinical performance often had excellent behavior in the non-technical items of “team interaction,” “anticipation,” “avoidance fixation,” and “focused communication.” Teams with a low or average clinical performance often neglected to consider analgesia, had delayed abandonment of the attempted vaginal delivery and insufficient use of appropriate fetal monitoring. Interrater reliability was high for both rater-teams, with an ICC for the non-technical skills of 0.83 (95% confidence interval [CI]: 0.71–0.88) and 0.84 for the clinical performance (95% CI: 0.74–0.90).ConclusionAlthough assisted vaginal delivery by vacuum extraction is generally considered to be an operator-dependent task, our findings suggest that teamwork and effective team interaction play crucial roles in achieving high clinical performance. Teamwork helped the consultant anticipate the next step, avoid fixation, ensure adequate analgesia, and maintain thorough fetal monitoring during delivery.

show abstract

Section: Discussionsupporting

confidence: 86%

Team performance during vacuum-assisted vaginal delivery: video review of obstetric multidisciplinary teams

Brogaard,

Rosvig,

Hjorth-Hansen

et al. 2024

Front. Med.

View full text Add to dashboard Cite

show abstract

“…This study only identified technical skills to be included in a SBT curriculum. However, excellent use of non-technical skills has been shown to improve clinical performance [23], and it is essential to include such skills when designing SBT courses. Whereas this study aimed to identify technical skills that should be included in a simulation-based curriculum in neonatology, most training occurs in the clinical setting.…”

Section: Discussionmentioning

confidence: 99%

Technical Skills Curriculum in Neonatology: A Modified European Delphi Study

Bay,

Breindahl,

Nielsen

et al. 2024

Neonatology

View full text Add to dashboard Cite

Introduction: Simulation-based training (SBT) aids healthcare providers in acquiring the technical skills necessary to improve patient outcomes and safety. However, since SBT may require significant resources, training all skills to a comparable extent is impractical. Hence, a strategic prioritization of technical skills is necessary. While the European Training Requirements in Neonatology provide guidance on necessary skills, they lack prioritization. We aimed to identify and prioritize technical skills for a SBT curriculum in neonatology. Methods: A three-round modified Delphi process of expert neonatologists and neonatal trainees was performed. In round one, the participants listed all the technical skills newly trained neonatologists should master. The content analysis excluded duplicates and non-technical skills. In round two, the Copenhagen Academy for Medical Education and Simulation Needs Assessment Formula (CAMES-NAF) was used to preliminarily prioritize the technical skills according to frequency, importance of competency, SBT impact on patient safety, and feasibility for SBT. In round three, the participants further refined and reprioritized the technical skills. Items achieving consensus (agreement of ≥75%) were included. Results: We included 168 participants from 10 European countries. The response rates in rounds two and three were 80% (135/168) and 87% (117/135), respectively. In round one, the participants suggested 1964 different items. Content analysis revealed 81 unique technical skills prioritized in round two. In round three, 39 technical skills achieved consensus and were included. Conclusion: We reached a European consensus on a prioritized list of 39 technical skills to be included in a SBT curriculum in neonatology.

show abstract

“…Teamwork is the key to resuscitation in a real clinical setting, and it could be improved through briefing and debriefing [ 48 , 49 ]. During a debriefing, the leader should identify strengths and weaknesses in a positive forum, where everyone understands that the only goal is to enhance future performance.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of high-fidelity simulation in advanced life support training: a systematic review and meta-analysis of randomized controlled trials

Zeng,

Wang,

Liu

et al. 2023

BMC Med Educ

View full text Add to dashboard Cite

Background Simulation is an increasingly used novel method for the education of medical professionals. This study aimed to systematically review the efficacy of high-fidelity (HF) simulation compared with low-fidelity (LF) simulation or no simulation in advanced life support (ALS) training. Methods A comprehensive search of the PubMed, Chinese Biomedicine Database, Embase, CENTRAL, ISI, and China Knowledge Resource Integrated Database was performed to identify randomized controlled trials (RCTs) that evaluated the use of HF simulation in ALS training. Quality assessment was based on the Cochrane Handbook for Systematic Reviews of Interventions version 5.0.1. The primary outcome was the improvement of knowledge and skill performance. The secondary outcomes included the participants’ confidence and satisfaction at the course conclusion, skill performance at one year, skill performance in actual resuscitation, and patient outcomes. Data were synthesized using the RevMan 5.4 software. Results Altogether, 25 RCTs with a total of 1,987 trainees were included in the meta-analysis. In the intervention group, 998 participants used HF manikins, whereas 989 participants received LF simulation-based or traditional training (classical training without simulation). Pooled data from the RCTs demonstrated a benefit in improvement of knowledge [standardized mean difference (SMD) = 0.38; 95% confidence interval (CI): 0.18–0.59, P = 0.0003, I2 = 70%] and skill performance (SMD = 0.63; 95% CI: 0.21–1.04, P = 0.003, I2 = 92%) for HF simulation when compared with LF simulation and traditional training. The subgroup analysis revealed a greater benefit in knowledge with HF simulation compared with traditional training at the course conclusion (SMD = 0.51; 95% CI: 0.20–0.83, P = 0.003, I2 = 61%). Studies measuring knowledge at three months, skill performance at one year, teamwork behaviors, participants’ satisfaction and confidence demonstrated no significant benefit for HF simulation. Conclusions Learners using HF simulation more significantly benefited from the ALS training in terms of knowledge and skill performance at the course conclusion. However, further research is necessary to enhance long-term retention of knowledge and skill in actual resuscitation and patient’s outcomes.

show abstract

Teamwork and Adherence to Guideline on Newborn Resuscitation—Video Review of Neonatal Interdisciplinary Teams

Cited by 13 publications

References 43 publications

Team performance during vacuum-assisted vaginal delivery: video review of obstetric multidisciplinary teams

Team performance during vacuum-assisted vaginal delivery: video review of obstetric multidisciplinary teams

Technical Skills Curriculum in Neonatology: A Modified European Delphi Study

Efficacy of high-fidelity simulation in advanced life support training: a systematic review and meta-analysis of randomized controlled trials

Contact Info

Product

Resources

About