scholarly journals Health Care Providers’ Performance, Mindset, and Attitudes Toward a Neonatal Resuscitation Computer-Based Simulator: Empirical Study

10.2196/21855 ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. e21855
Author(s):  
Maria Cutumisu ◽  
Simran K Ghoman ◽  
Chang Lu ◽  
Siddhi D Patel ◽  
Catalina Garcia-Hidalgo ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Nurse Practitioners ◽  
Neonatal Resuscitation ◽  
Growth Mindset ◽  
Care Providers ◽  
Actual Performance ◽  
Action Sequence ◽  
Resuscitation Training ◽  
Computer Based

Background Neonatal resuscitation involves a complex sequence of actions to establish an infant’s cardiorespiratory function at birth. Many of these responses, which identify the best action sequence in each situation, are taught as part of the recurrent Neonatal Resuscitation Program training, but they have a low incidence in practice, which leaves health care providers (HCPs) less prepared to respond appropriately and efficiently when they do occur. Computer-based simulators are increasingly used to complement traditional training in medical education, especially in the COVID-19 pandemic era of mass transition to digital education. However, it is not known how learners’ attitudes toward computer-based learning and assessment environments influence their performance. Objective This study explores the relation between HCPs’ attitudes toward a computer-based simulator and their performance in the computer-based simulator, RETAIN (REsuscitation TrAINing), to uncover the predictors of performance in computer-based simulation environments for neonatal resuscitation. Methods Participants were 50 neonatal HCPs (45 females, 4 males, 1 not reported; 16 respiratory therapists, 33 registered nurses and nurse practitioners, and 1 physician) affiliated with a large university hospital. Participants completed a demographic presurvey before playing the game and an attitudinal postsurvey after completing the RETAIN game. Participants’ survey responses were collected to measure attitudes toward the computer-based simulator, among other factors. Knowledge on neonatal resuscitation was assessed in each round of the game through increasingly difficult neonatal resuscitation scenarios. This study investigated the moderating role of mindset on the association between the perceived benefits of understanding the terminology used in the computer-based simulator, RETAIN, and their performance on the neonatal resuscitation tasks covered by RETAIN. Results The results revealed that mindset moderated the relation between participants’ perceived terminology used in RETAIN and their actual performance in the game (F3,44=4.56, R2=0.24, adjusted R2=0.19; P=.007; estimate=–1.19, SE=0.38, t44=–3.12, 95% CI –1.96 to –0.42; P=.003). Specifically, participants who perceived the terminology useful also performed better but only when endorsing more of a growth mindset; they also performed worse when endorsing more of a fixed mindset. Most participants reported that they enjoyed playing the game. The more the HCPs agreed that the terminology in the tutorial and in the game was accessible, the better they performed in the game, but only when they reported endorsing a growth mindset exceeding the average mindset of all the participants (F3,44=6.31, R2=0.30, adjusted R2=0.25; P=.001; estimate=–1.21, SE=0.38, t44=−3.16, 95% CI –1.99 to –0.44; P=.003). Conclusions Mindset moderates the strength of the relationship between HCPs’ perception of the role that the terminology employed in a game simulator has on their performance and their actual performance in a computer-based simulator designed for neonatal resuscitation training. Implications of this research include the design and development of interactive learning environments that can support HCPs in performing better on neonatal resuscitation tasks.

scholarly journals Health Care Providers’ Performance, Mindset, and Attitudes Toward a Neonatal Resuscitation Computer-Based Simulator: Empirical Study (Preprint)

2020 ◽  
Author(s):  
Maria Cutumisu ◽  
Simran K Ghoman ◽  
Chang Lu ◽  
Siddhi D Patel ◽  
Catalina Garcia-Hidalgo ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Nurse Practitioners ◽  
Neonatal Resuscitation ◽  
Growth Mindset ◽  
Care Providers ◽  
Actual Performance ◽  
Action Sequence ◽  
Resuscitation Training ◽  
Computer Based

BACKGROUND Neonatal resuscitation involves a complex sequence of actions to establish an infant’s cardiorespiratory function at birth. Many of these responses, which identify the best action sequence in each situation, are taught as part of the recurrent Neonatal Resuscitation Program training, but they have a low incidence in practice, which leaves health care providers (HCPs) less prepared to respond appropriately and efficiently when they do occur. Computer-based simulators are increasingly used to complement traditional training in medical education, especially in the COVID-19 pandemic era of mass transition to digital education. However, it is not known how learners’ attitudes toward computer-based learning and assessment environments influence their performance. OBJECTIVE This study explores the relation between HCPs’ attitudes toward a computer-based simulator and their performance in the computer-based simulator, RETAIN (REsuscitation TrAINing), to uncover the predictors of performance in computer-based simulation environments for neonatal resuscitation. METHODS Participants were 50 neonatal HCPs (45 females, 4 males, 1 not reported; 16 respiratory therapists, 33 registered nurses and nurse practitioners, and 1 physician) affiliated with a large university hospital. Participants completed a demographic presurvey before playing the game and an attitudinal postsurvey after completing the RETAIN game. Participants’ survey responses were collected to measure attitudes toward the computer-based simulator, among other factors. Knowledge on neonatal resuscitation was assessed in each round of the game through increasingly difficult neonatal resuscitation scenarios. This study investigated the moderating role of mindset on the association between the perceived benefits of understanding the terminology used in the computer-based simulator, RETAIN, and their performance on the neonatal resuscitation tasks covered by RETAIN. RESULTS The results revealed that mindset moderated the relation between participants’ perceived terminology used in RETAIN and their actual performance in the game (<i>F</i><sub>3,44</sub>=4.56, R<sup>2</sup>=0.24, adjusted R<sup>2</sup>=0.19; <i>P</i>=.007; estimate=–1.19, SE=0.38, t<sub>44</sub>=–3.12, 95% CI –1.96 to –0.42; <i>P</i>=.003). Specifically, participants who perceived the terminology useful also performed better but only when endorsing more of a growth mindset; they also performed worse when endorsing more of a fixed mindset. Most participants reported that they enjoyed playing the game. The more the HCPs agreed that the terminology in the tutorial and in the game was accessible, the better they performed in the game, but only when they reported endorsing a growth mindset exceeding the average mindset of all the participants (<i>F</i><sub>3,44</sub>=6.31, R<sup>2</sup>=0.30, adjusted R<sup>2</sup>=0.25; <i>P</i>=.001; estimate=–1.21, SE=0.38, t<sub>44</sub>=−3.16, 95% CI –1.99 to –0.44; <i>P</i>=.003). CONCLUSIONS Mindset moderates the strength of the relationship between HCPs’ perception of the role that the terminology employed in a game simulator has on their performance and their actual performance in a computer-based simulator designed for neonatal resuscitation training. Implications of this research include the design and development of interactive learning environments that can support HCPs in performing better on neonatal resuscitation tasks.

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

2021 ◽  
Vol 8 ◽  
Author(s):  
Simran K. Ghoman ◽  
Maria Cutumisu ◽  
Georg M. Schmölzer
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Nurse Practitioners ◽  
Health Care Professionals ◽  
Digital Simulation ◽  
Neonatal Resuscitation ◽  
Care Providers ◽  
Resuscitation Training ◽  
Post Test ◽  
Over Time

Purpose: To safely care for their newborn patients, health-care professionals (HCP) must undergo frequent training to improve and maintain neonatal resuscitation knowledge and skills. However, the current approach to neonatal resuscitation simulation training is time and resource-intensive, and often inaccessible. Digital neonatal resuscitation simulation may present a convenient alternative for more frequent training.Method: Fifty neonatal HCPs participated in the study (44 female; 27 nurses, 3 nurse practitioners, 14 respiratory therapists, 6 doctors). This study was conducted at a tertiary perinatal center in Edmonton, Canada from April–August 2019, with 2-month (June–October 2019) and 5-month (September 2019–January 2020) follow-up. Neonatal HCPs were recruited by volunteer sampling to complete a demographic survey, pre-test (baseline knowledge), two digital simulation scenarios (intervention), and post-test (knowledge acquisition). Two months later, participants repeated the post-test (knowledge retention). Five months after the initial intervention, participants completed a post-test using a table-top simulation (knowledge transfer). Longitudinal analyses were used to compare participants' performance over time.Results: Overall the proportion of correct performance increased: 21/50 (42%) passed the pre-test, 39/50 (78%) the post-test, 30/43 (70%) the 2-month post-test, and 32/40 (80%) the 5-month post-test. GLMM and GEE analyses revealed that performance on all post-tests was significantly better than the performance on the pre-test. Therefore, training with the RETAIN digital simulation effectively improves, maintains, and transfers HCPs' neonatal resuscitation knowledge.Conclusions: Digital simulation improved, maintained, and helped transfer HCPs' neonatal resuscitation knowledge over time. Digital simulation presents a promising approach for frequent neonatal resuscitation training, particularly for distance-learning applications.

Nurse Practitioner Challenges to the Orthodox Structure of Health Care Delivery: Regulation and Restraints on Trade

1985 ◽  
Vol 11 (2) ◽  
pp. 195-225
Author(s):  
Karla Kelly
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Delivery ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Allied Health ◽  
Care Delivery ◽  
The United States ◽  
Care Providers ◽  
Allied Health Care

AbstractUntil recently, physicians have been the primary health care providers in the United States. In response to the rising health care costs and public demand of the past decade, allied health care providers have challenged this orthodox structure of health care delivery. Among these allied health care providers are nurse practitioners, who have attempted to expand traditional roles of the registered nurse.This article focuses on the legal issues raised by several major obstacles to the expansion of nurse practitioner services: licensing restrictions, third party reimbursement policies, and denial of access to medical facilities and physician back-up services. The successful judicial challenges to discriminatory practices against other allied health care providers will be explored as a solution to the nurse practitioners’ dilemma.

scholarly journals Is Video Laryngoscopy the Optimal Tool for Successful Intubation in a Neonatal Simulation Setting? A Single-Center Experience

2020 ◽  
Vol 10 (01) ◽  
pp. e5-e10 ◽  
Author(s):  
Iram Musharaf ◽  
Sibasis Daspal ◽  
John Shatzer
Keyword(s):  
Health Care ◽  
Success Rate ◽  
Health Care Providers ◽  
Nurse Practitioners ◽  
Clinical Training ◽  
Video Laryngoscopy ◽  
Care Providers ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Abstract Background Endotracheal intubation is a skill required for resuscitation. Due to various reasons, intubation opportunities are decreasing for health care providers. Objective To compare the success rate of video laryngoscopy (VL) and direct laryngoscopy (DL) for interprofessional neonatal intubation skills in a simulated setting. Methods This was a prospective nonrandomized simulation crossover trial. Twenty-six participants were divided into three groups based on their frequency of intubation. Group 1 included pediatric residents; group 2 respiratory therapists and transport nurses; and group 3 neonatal nurse practitioners and physicians working in neonatology. We compared intubation success rate, intubation time, and laryngoscope preference. Results Success rates were 100% for both DL and VL in groups 1 and 2, and 88.9% for DL and 100% for VL in group 3. Median intubation times for DL and VL were 22 seconds (interquartile range [IQR] 14.3–22.8 seconds) and 12.5 seconds (IQR 10.3–38.8 seconds) in group 1 (p = 0.779); 17 seconds (IQR 8–21 seconds) and 12 seconds (IQR 9–16.5 seconds) in group 2 (p = 0.476); and 11 seconds (IQR 7.5–15.5 seconds) and 15 seconds (IQR 11.5–36 seconds) in group 3 (p = 0.024). Conclusion We conclude that novice providers tend to perform better with VL, while more experienced providers perform better with DL. In this era of decreased clinical training opportunities, VL may serve as a useful tool to teach residents and other novice health care providers.

scholarly journals Feasibility of an augmented reality cardiopulmonary resuscitation training system for health care providers

Heliyon ◽  
2019 ◽  
Vol 5 (8) ◽  
pp. e02205 ◽  
Author(s):  
Steve Balian ◽  
Shaun K. McGovern ◽  
Benjamin S. Abella ◽  
Audrey L. Blewer ◽  
Marion Leary
Keyword(s):  
Health Care ◽  
Augmented Reality ◽  
Cardiopulmonary Resuscitation ◽  
Health Care Providers ◽  
Training System ◽  
Care Providers ◽  
Resuscitation Training

Trauma-Informed Care With Childhood Maltreatment Survivors: What Do Maternity Professionals Want to Learn?

2014 ◽  
Vol 4 (3) ◽  
pp. 191-201 ◽  
Author(s):  
Kristen Choi ◽  
Julia S. Seng
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Nurse Practitioners ◽  
Health Care Professionals ◽  
Childhood Maltreatment ◽  
Perinatal Care ◽  
Care Providers ◽  
History Of ◽  
Maternity Health ◽  
Maternity Health Care

BACKGROUND: Posttraumatic stress disorder (PTSD) affects 8% of pregnant women, and the biggest risk factor for pregnancy PTSD is childhood maltreatment. The care they receive can lead to positive outcomes or to retraumatization and increased morbidity. The purpose of this study is to gather information from a range of clinicians about their continuing education needs to provide perinatal care to women with a maltreatment history and PTSD.METHOD: Maternity health care professionals were interviewed by telephone. Network sampling and purposive sampling were used to include physicians, nurse practitioners, midwives, nurses, and doulas (n = 20), and results were derived from content analysis.RESULTS: Most providers received little or no training on the issue of caring for women with a history of childhood maltreatment or PTSD during their original education but find working with this type of patient rewarding and wish to learn how to provide better care. Providers identified a range of educational needs and recommend offering a range of formats and time options for learning.CONCLUSIONS: Maternity health care providers desire to work effectively with survivor moms and want to learn best practices for doing so. Thus, educational programming addressing provider needs and preferences should be developed and tested to improve care experiences and pregnancy outcomes for women with a history of trauma or PTSD.

scholarly journals Endoscopy by Nonphysicians

2007 ◽  
Vol 21 (1) ◽  
pp. 17-18 ◽  
Author(s):  
Elaine R Gossman
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Nurse Practitioners ◽  
Physician Assistants ◽  
The United States ◽  
Current Status ◽  
Care Providers ◽  
Kaiser Permanente ◽  
Efficient System ◽  
Effective Manner

In 1945, Henry J Kaiser organized a group of physicians to provide health care for shipyard workers and their families. His foundation, Kaiser Permanente (USA), has developed into a prepaid health plan facility serving 8.4 million members in nine states and in Washington, DC, within the United States. It aspires to provide high quality, affordable, integrated health care within an organized, efficient system. A focus on preventive care in a cost-effective manner is a high priority. The Kaiser Permanente northwest region (covering northwest Oregon and southwest Washington) serves nearly one-half of a million members. Our region has utilized nurse practitioners (NPs) and physician assistants (PAs) (allied health care providers) in a variety of capacities for many years. The present paper reviews the background and current status of their role in endoscopy.

scholarly journals Quality of Basic Care During Neonatal Resuscitation Among Health Care Providers at Three District Hospitals in Kigali

2020 ◽  
Vol 3 (2) ◽  
pp. 225-237
Author(s):  
Kellen Muganwa ◽  
Alice Muhayimana ◽  
Joella Mukashyaka ◽  
Pamela Meharry
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Work Experience ◽  
Neonatal Resuscitation ◽  
Care Providers ◽  
Cross Sectional ◽  
Basic Care ◽  
District Hospitals ◽  
One Year

Background Globally, about 10% of neonates require extra respiratory support to initiate breathing at birth. Over a million neonatal deaths could be prevented with quality basic care during neonatal resuscitation. Objective To determine the quality of care (QoC) of basic NR at birth among health care providers (HCPs) at three district hospitals in Kigali. Methods A descriptive cross-sectional study was conducted. Thirty-six HCPs were observed 2-3 times using a structured checklist. Descriptive and inferential statistics were used to analyze the data.  Results The majority had ‘good’ QoC scores for drying and stimulation (74.7%), and fair scores for airway clearance (85.1%). Some had poor scores for advanced bag and mask ventilation (BMV) (13%). Maternity work experience (1-5 years) was significantly associated with good quality drying and stimulation (p = 0.03), initial BMV (p = 0.02), and advanced BMV (p = 0.03), than HCPs with less than one-year experience.  Conclusion Maternity work experience of more than one year significantly improved the QoC during neonatal resuscitation. More NR support during the first year of work and regular NR refresher training would improve neonatal outcomes.  Rwanda J Med Health Sci 2020;3(2):225-237

scholarly journals Identifying the know-do gap in evidence-based neonatal care practices among informal health care providers—A cross-sectional study from Ujjain, India

2020 ◽  
Author(s):  
Isaac Gikandi Mungai ◽  
Sumit Singh Baghel ◽  
Suchi Soni ◽  
Shailja Vagela ◽  
Megha Sharma ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Service Providers ◽  
Neonatal Resuscitation ◽  
Neonatal Care ◽  
Evidence Based ◽  
Care Providers ◽  
Cross Sectional ◽  
Evidence Based Practices ◽  
Number Of Patients

Abstract Background More than a quarter of global neonatal deaths are reported from India, and a large proportion of these deaths are preventable. However, in the absence of robust public health care systems in several states in India, informal health care providers (IHCPs) with no formal medical education are the first contact service providers. The aim of this study was to assess the knowledge of IHCPs in basic evidence-based practices in neonatal care in Ujjain district and investigated factors associated with differences in levels of knowledge. Methods A cross-sectional survey was conducted using a questionnaire with multiple-choice questions covering the basic elements of neonatal care. The collective score per question among the respondents was calculated. The score achieved by each respondent was calculated, grouped into either “fair” or “low”, and then checked for association with the practitioners’ age and years of experience, number of patients examined per day, and whether they attended children in their practice. Results Of the 945 IHCPs approached, 830 (88%) participated in the study. Of the potential 39,840 points, only an average of 18,483 (46%) were achieved, indicating a knowledge gap. Although these providers could identify key tenets of enhancing survival chances of neonates, they scored low on the specifics of cord care, breastfeeding, vitamin K use to prevent neonatal hemorrhage, and identification and care of low-birth-weight babies. The practitioners particularly lacked knowledge about neonatal resuscitation, and only a small proportion reported following up on immunizations in children they attended. Fair knowledge of IHCPs was significantly associated with attending more than 10 but less than 50 patients per day and of being aged between 35 and 45 years. Offering pediatric consultations was not significantly associated with achieving a fair score. Conclusions The present study highlighted that know-do gap exists in evidence-based practices for all key areas of neonatal care tested among the IHCPs. The study provides the evidence that educational interventions targeting IHCPs can improve neonatal care services and is an innovative way to reach a large rural population in the study setting.

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