POV Video and Mental Practice Training for Neonatal LMA Insertion

Combined Use of Point-of-View (POV) Video and Mental Practice Training Versus Standard Demonstration for Neonatal LMA Insertion by Novice Healthcare Professionals: A Prospective Randomized Simulation Study

This prospective, randomized, single-blind simulation study aims to evaluate and compare the educational efficacy of a hybrid instructional modality-combining point-of-view (POV) video training and structured mental practice (MP)-against standard instructor-led live demonstration for neonatal laryngeal mask airway (LMA) insertion training among novice healthcare professionals. Learning neonatal airway management skills presents unique educational and cognitive challenges, especially for non-physician providers who are frequently required to perform these high-stakes interventions during the Neonatal Resuscitation Program (NRP) curricula.

A total of 52 eligible healthcare professionals (including physicians, midwives, nurses, paramedics, and emergency medical technicians) with no prior neonatal LMA insertion experience will be prospectively enrolled and randomly allocated into two equal parallel groups (n=26 per group). Group A (Control) will receive a standard, step-by-step 5-minute live instructor demonstration on a high-fidelity term neonatal simulator. Group B (Intervention) will view a 3-minute standardized POV video captured from a first-person perspective via a head-mounted action camera worn by an expert instructor, immediately followed by a 1-minute structured mental rehearsal, with no live demonstration provided.

Following the respective educational interventions, all participants will individually perform the neonatal LMA insertion on the simulator in a separate room. A trained evaluator, who remains strictly blinded to the group assignments, will record the performance outcomes. The primary outcome measures are the objective total OSCE score (evaluated via a 22-item standardized checklist) and the physical procedural completion time in seconds. Secondary outcomes include first-attempt success rates, critical error rates, instances of excessive force application, airway trauma or procedural failure, and subjective cognitive workload dimensions assessed via the NASA Task Load Index (NASA-TLX) questionnaire. The findings will provide insights into scalable, cost-effective, and cognitively optimized learning models for integration into neonatal resuscitation training frameworks.

Study Overview

• Status: Completed
• Conditions: Airway Management; Simulation Training; Neonatal Resuscitation; Clinical Competence
• Intervention / Treatment: Other: Standard Instructor Demonstration; Other: POV Video and Mental Practice

• Study Type: Interventional
• Enrollment (Actual): 52
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Kahramanmaraş, Turkey (Türkiye), 46100
    • Kahramanmaraş Sütçü İmam University, Faculty of Medicine

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

1. Being a licensed healthcare professional (physicians, midwives, nurses, paramedics, or emergency medical technicians) currently participating in or eligible for the Neonatal Resuscitation Program (NRP) training.
2. Having no prior practical, clinical, or simulator-based experience with neonatal laryngeal mask airway (LMA) insertion.
3. Voluntarily consenting to participate in the study and complete all evaluation procedures (OSCE and NASA-TLX).

Exclusion Criteria:

1. Having previous hands-on experience or formal advanced training specifically in neonatal LMA stabilization or insertion.
2. Declining to participate or failing to complete any phase of the allocated educational intervention or subsequent assessment.
3. Having visual, auditory, or cognitive impairments that would interfere with viewing the point-of-view (POV) video or performing the structured mental practice.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Group A - Standard Demonstration; Participants receive a standardized, step-by-step 5-minute live instructor demonstration of neonatal laryngeal mask airway (LMA) insertion on a high-fidelity term neonatal simulator, adhering to current Neonatal Resuscitation Program (NRP) guidelines.	Other: Standard Instructor Demonstration; A 5-minute, step-by-step live instructor demonstration of neonatal LMA insertion on a simulator.
Experimental: Group B - POV Video + Mental Practice; Participants view a 3-minute standardized point-of-view (POV) video captured by a head-mounted action camera worn by an experienced instructor, displaying the LMA insertion from a first-person perspective with expert narration. Immediately after, participants perform a 1-minute structured mental rehearsal.	Other: POV Video and Mental Practice; A 3-minute first-person point-of-view video combined with 1 minute of structured mental rehearsal.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Objective Structured Clinical Examination (OSCE) Score	A 22-item standardized checklist specifically developed based on the Neonatal Resuscitation Program (NRP) guidelines to evaluate the technical proficiency of neonatal laryngeal mask airway (LMA) insertion. Each step is scored, and higher total scores indicate superior clinical performance.	Immediately after the educational intervention (Day 1).
Procedural Completion Time	The total physical time measured in seconds from the moment the participant picks up the laryngeal mask airway (LMA) device until the successful placement and initial ventilation on the high-fidelity neonatal simulator.	Immediately after the educational intervention (Day 1).

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Subjective Workload (NASA-TLX Score)	The NASA Task Load Index (NASA-TLX) questionnaire will be used to evaluate the multidimensional subjective workload experienced by participants across 6 subscales: mental demand, physical demand, temporal demand, performance, effort, and frustration. Total score ranges from 0 to 100, where higher scores reflect higher cognitive and physical workload.	Immediately after the clinical performance assessment (Day 1).

Collaborators and Investigators

• Sponsor: Kahramanmaras Sutcu Imam University

Study record dates

Study Major Dates

• Study Start (Actual): June 15, 2026
• Primary Completion (Actual): June 19, 2026
• Study Completion (Actual): June 19, 2026

Study Registration Dates

• First Submitted: June 25, 2026
• First Submitted That Met QC Criteria: June 25, 2026
• First Posted (Actual): July 1, 2026

Study Record Updates

• Last Update Posted (Actual): July 1, 2026
• Last Update Submitted That Met QC Criteria: June 25, 2026
• Last Verified: June 1, 2026

More Information

Terms related to this study

• Other Study ID Numbers: KSUEK-2026/18

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No