Effect of Computer Debriefing on Acquisition and Retention of Learning After Screen-Based Simulation of Neonatal Resuscitation: Randomized Controlled Trial

Daphne Michelet, Jessy Barre, Jennifer Truchot, Marie-Aude Piot, Philippe Cabon, Antoine Tesniere, Daphne Michelet, Jessy Barre, Jennifer Truchot, Marie-Aude Piot, Philippe Cabon, Antoine Tesniere

Abstract

Background: Debriefing is key in a simulation learning process.

Objective: This study focuses on the impact of computer debriefing on learning acquisition and retention after a screen-based simulation training on neonatal resuscitation designed for midwifery students.

Methods: Midwifery students participated in 2 screen-based simulation sessions, separated by 2 months, session 1 and session 2. They were randomized in 2 groups. Participants of the debriefing group underwent a computer debriefing focusing on technical skills and nontechnical skills at the end of each scenario, while the control group received no debriefing. In session 1, students participated in 2 scenarios of screen-based simulation on neonatal resuscitation. During session 2, the students participated in a third scenario. The 3 scenarios had an increasing level of difficulty, with the first representing the baseline level. Assessments included a knowledge questionnaire on neonatal resuscitation, a self-efficacy rating, and expert evaluation of technical skills as per the Neonatal Resuscitation Performance Evaluation (NRPE) score and of nontechnical skills as per the Anaesthetists' Non-Technical Skills (ANTS) system. We compared the results of the groups using the Mann-Whitney U test.

Results: A total of 28 midwifery students participated in the study. The participants from the debriefing group reached higher ANTS scores than those from the control group during session 1 (13.25 vs 9; U=47.5; P=.02). Their scores remained higher, without statistical difference during session 2 (10 vs 7.75; P=.08). The debriefing group had higher self-efficacy ratings at session 2 (3 vs 2; U=52; P=.02). When comparing the knowledge questionnaires, the significant baseline difference (13 for debriefing group vs 14.5 for control group, P=.05) disappeared at the end of session 1 and in session 2. No difference was found for the assessment of technical skills between the groups or between sessions.

Conclusions: Computer debriefing seems to improve nontechnical skills, self-efficacy, and knowledge when compared to the absence of debriefing during a screen-based simulation. This study confirms the importance of debriefing after screen-based simulation.

Trial registration: ClinicalTrials.gov NCT03844009; https://ichgcp.net/clinical-trials-registry/NCT03844009.

Keywords: debriefing; medical education; midwifery; neonatal; neonatal resuscitation; screen-based simulation; simulation.

Conflict of interest statement

Conflicts of Interest: None declared.

©Daphne Michelet, Jessy Barre, Jennifer Truchot, Marie-Aude Piot, Philippe Cabon, Antoine Tesniere. Originally published in JMIR Serious Games (http://games.jmir.org), 11.08.2020.

Figures

Figure 1
Figure 1
Participant during a scenario on the left and screenshot of the interface and virtual environment of Périnatsims screen-based simulation on the right.
Figure 2
Figure 2
Experiment design.
Figure 3
Figure 3
Computer debriefing of technical skills.
Figure 4
Figure 4
Self-debriefing of nontechnical skills.

References

    1. Ryan C, Clark L, Malone A, Ahmed S. The effect of a structured neonatal resuscitation program on delivery room practices. Neonatal Netw. 1999;18:25. doi: 10.1891/0730-0832.18.1.25. doi: 10.1891/0730-0832.18.1.25.
    1. Curran V, Aziz K, O?Young S, Bessell C. Evaluation of the effect of a computerized training simulator (ANAKIN) on the retention of neonatal resuscitation skills. Teach Learn Med. 2004;16:157. doi: 10.1207/s15328015tlm1602_7. doi: 10.1207/s15328015tlm1602_7.
    1. Pearlman S, Zern S, Blackson T, Ciarlo J, Mackley A, Locke R. Use of neonatal simulation models to assess competency in bag-mask ventilation. J Perinatol. 2016;36:242. doi: 10.1038/jp.2015.175. doi: 10.1038/jp.2015.175.
    1. Thomas E, Taggart B, Crandell S, Lasky R, Williams A, Love L. Teaching teamwork during the Neonatal Resuscitation Program: a randomized trial. J Perinatol. 2007;27:a. doi: 10.1038/sj.jp.7211771. doi: 10.1038/sj.jp.7211771.
    1. Thomas E, Williams A, Reichman E, Lasky R, Crandell S, Taggart W. Team training in the neonatal resuscitation program for interns: teamwork and quality of resuscitations. Pediatrics. 2010;125:539. doi: 10.1542/peds.2009-1635. doi: 10.1542/peds.2009-1635.
    1. Patel A, Khatib M, Kurhe K, Bhargava S, Bang A. Impact of neonatal resuscitation trainings on neonatal and perinatal mortality: a systematic review and meta-analysis. BMJ Paediatr Open. 2017;1:a. doi: 10.1136/bmjpo-2017-000183. doi: 10.1136/bmjpo-2017-000183.
    1. Malmström B, Nohlert E, Ewald U, Widarsson M. Simulation-based team training improved the self-assessed ability of physicians, nurses and midwives to perform neonatal resuscitation. Acta Paediatr. 1992:1273. doi: 10.1111/apa.13861. doi: 10.1111/apa.13861.
    1. Lee M, Brown L, Bender J, Machan J, Overly F. A medical simulation-based educational intervention for emergency medicine residents in neonatal resuscitation. Acad Emerg Med. 2012 May;19(5):577–85. doi: 10.1111/j.1553-2712.2012.01361.x. doi: 10.1111/j.1553-2712.2012.01361.x.
    1. Mileder L, Urlesberger B, Szyld E, Roehr C, Schmölzer G. Simulation-based neonatal and infant resuscitation teaching: a systematic review of randomized controlled trials. Klin Padiatr. 2014;226:a. doi: 10.1055/s-0034-1372621. doi: 10.1055/s-0034-1372621.
    1. Haerling K. Cost-Utility Analysis of Virtual and Mannequin-Based Simulation. Simul Healthc. 2018;13:33. doi: 10.1097/SIH.0000000000000280. doi: 10.1097/sih.0000000000000280.
    1. Gentry S, Gauthier A, L'Estrade EB, Wortley D, Lilienthal A, Tudor CL. Serious Gaming and Gamification Education in Health Professionsystematic Review. J Med Internet Res. 2019;21:e12994. doi: 10.2196/12994. doi: 10.2196/12994.
    1. Barré J, Michelet D, Job A, Truchot J, Cabon P, Delgoulet C Does Repeated Exposure to Critical Situations in a Screen-Based Simulation Improve the Self-Assessment of Non-Technical Skills in Postpartum Hemorrhage Management? Simul Gaming 2019. Simulation and gaming. 2019:1046878119827324. doi: 10.1177/1046878119827324. doi: 10.1177/1046878119827324.
    1. Ma M, Jain L, Anderson P. vol. 1. Springer. Verlag Berlin Heidelberg: Springer; 2014. Virtual, augmented reality and serious games for healthcare 1.
    1. Sawyer T, Umoren R, Gray M. Neonatal resuscitation: advances in training and practice. Adv Med Educ Pract. 2017;8:a. doi: 10.2147/AMEP.S109099. doi: 10.2147/amep.s109099.
    1. Cheng A, Eppich W, Grant V, Sherbino J, Zendejas B, Cook D. Debriefing for technology-enhanced simulation: a systematic review and meta-analysis. Med Educ. 2014;48:a. doi: 10.1111/medu.12432. doi: 10.1111/medu.12432.
    1. Sawyer T, Eppich W, Brett-Fleegler M, Grant V, Cheng A. More Than One Way to Debrief: A Critical Review of Healthcare Simulation Debriefing Methods. Simul Healthc. 2016;11:A. doi: 10.1097/SIH.0000000000000148. doi: 10.1097/sih.0000000000000148.
    1. Levett-Jones T, Lapkin S. A systematic review of the effectiveness of simulation debriefing in health professional education. Nurse Educ Today. 2014;34:e58–63. doi: 10.1016/j.nedt.2013.09.020. doi: 10.1016/j.nedt.2013.09.020.
    1. Kolbe M, Grande B, Spahn D. Briefing and debriefing during simulation-based training and beyond: Content, structure, attitude and setting. Best Pract Res Clin Anaesthesiol. 2015;29:87. doi: 10.1016/j.bpa.2015.01.002. doi: 10.1016/j.bpa.2015.01.002.
    1. Chronister C, Brown D. Comparison of Simulation Debriefing Methods. Clin Simul Nurs. 2012;8:e281. doi: 10.1016/j.ecns.2010.12.005. doi: 10.1016/j.ecns.2010.12.005.
    1. Boet S, Bould M, Bruppacher H, Desjardins F, Chandra D, Naik V. Looking in the mirrorlf-debriefing versus instructor debriefing for simulated crises. Crit Care Med. 2011;39:1377. doi: 10.1097/CCM.0b013e31820eb8be. doi: 10.1097/ccm.0b013e31820eb8be.
    1. Crookall D. Serious Games, Debriefing, and Simulation/Gaming as a Discipline. Simulation & Gaming. 2011 Jan 06;41(6):898–920. doi: 10.1177/1046878110390784.
    1. Pasquier Pierre, Mérat Stéphane, Malgras Brice, Petit Ludovic, Queran Xavier, Bay Christian, Boutonnet Mathieu, Jault Patrick, Ausset Sylvain, Auroy Yves, Perez Jean Paul, Tesnière Antoine, Pons François, Mignon Alexandre. A Serious Game for Massive Training and Assessment of French Soldiers Involved in Forward Combat Casualty Care (3D-SC1): Development and Deployment. JMIR Serious Games. 2016 May 18;4(1):e5. doi: 10.2196/games.5340.
    1. Roy K, Miller M, Schmidt K, Sagy M. Pediatric residents experience a significant decline in their response capabilities to simulated life-threatening events as their training frequency in cardiopulmonary resuscitation decreases. Pediatr Crit Care Med. 2011;12:e141–144. doi: 10.1097/PCC.0b013e3181f3a0d1. doi: 10.1097/pcc.0b013e3181f3a0d1.
    1. Kaczorowski J, Levitt C, Hammond M, Outerbridge E, Grad R, Rothman A. Retention of neonatal resuscitation skills and knowledge: a randomized controlled trial. Fam Med. 1998;30:11.
    1. Kudreviciene A, Nadisauskiene R, Tameliene R, Tamelis A, Nedzelskiene I, Dobozinskas P. Initial neonatal resuscitationkill retention after the implementation of the novel 24/7 HybridLab® learning system. J Matern-Fetal Neonatal Med. 2019;32:1230. doi: 10.1080/14767058.2017.1402881. doi: 10.1080/14767058.2017.1402881.
    1. Au Kelly, Lam Darren, Garg Nitan, Chau Anthony, Dzwonek Agata, Walker Benjamin, Tremblay Luc, Boet Sylvain, Bould M Dylan. Improving skills retention after advanced structured resuscitation training: A systematic review of randomized controlled trials. Resuscitation. 2019 May;138:284–296. doi: 10.1016/j.resuscitation.2019.03.031.
    1. Anderson Robert, Sebaldt Alexandre, Lin Yiqun, Cheng Adam. Optimal training frequency for acquisition and retention of high-quality CPR skills: A randomized trial. Resuscitation. 2019 Feb;135:153–161. doi: 10.1016/j.resuscitation.2018.10.033.
    1. Thomas EJ. Translating teamwork behaviours from aviation to healthcare: development of behavioural markers for neonatal resuscitation. Quality and Safety in Health Care. 2004 Oct 01;13(suppl_1):i57–i64. doi: 10.1136/qhc.13.suppl_1.i57. doi: 10.1136/qshc.2004.009811.
    1. Bélondrade P, Lefort H, Bertho K, Perrochon J, Jost D. Tourtier J-P. Anaesth Crit Care Pain Med. 2016:17. doi: 10.1016/j.accpm.2015.06.004. doi: 10.1016/j.accpm.2015.06.004.
    1. van DHP, van TL, van DHM, van DLJ. Assessment of neonatal resuscitation skills: a reliable and valid scoring system. Resuscitation. 2006;71:a. doi: 10.1016/j.resuscitation.2006.04.009. doi: 10.1016/j.resuscitation.2006.04.009.
    1. Fletcher G, Flin R, McGeorge P, Glavin R, Maran N, Patey R. Anaesthetists? Non-Technical Skills (ANTS)valuation of a behavioural marker system. Br J Anaesth. 2003;90:8. doi: 10.1037/e576952012-027.
    1. Hagemann V, Herbstreit F, Kehren C, Chittamadathil J, Wolfertz S, Dirkmann D Does teaching non-technical skills to medical students improve those skills and simulated patient outcome? Int J Med Educ 2017;8?13. Int J Med Educ. 2017:101. doi: 10.5116/ijme.58c1.9f0d. doi: 10.5116/ijme.58c1.9f0d.
    1. Cavicchiolo M, Cavallin F, Staffler A, Pizzol D, Matediana E, Wingi O. Decision Making and Situational Awareness in Neonatal Resuscitation in Low Resource Settings. Resuscitation. 2018 doi: 10.1016/j.resuscitation.2018.10.034. doi: 10.1016/j.resuscitation.2018.10.034.
    1. Roh Y, Lee W, Chung H, Park Y. The effects of simulation-based resuscitation training on nurses? self-efficacy and satisfaction. Nurse Educ Today. 2013;33:123. doi: 10.1016/j.nedt.2011.11.008. doi: 10.1016/j.nedt.2011.11.008.
    1. Tofil N, Peterson D, Wheeler J, Youngblood A, Zinkan J, Lara D. Repeated versus varied case selection in pediatric resident simulation. J Grad Med Educ?9. 2014;6:275. doi: 10.4300/JGME-D-13-00099.1. doi: 10.4300/jgme-d-13-00099.1.
    1. Graafland M, Schraagen J, Schijven M. Systematic review of serious games for medical education and surgical skills training. Br J Surg. 2012;99:1322. doi: 10.1002/bjs.8819. doi: 10.1002/bjs.8819.
    1. Garden A L, Le Fevre D M, Waddington H L, Weller J M. Debriefing after simulation-based non-technical skill training in healthcare: a systematic review of effective practice. Anaesth Intensive Care. 2015 May;43(3):300–8. doi: 10.1177/0310057X1504300303.
    1. Rondon S, Sassi F, Furquim DAC. Computer game-based and traditional learning method: a comparison regarding students? knowledge retention. BMC Med Educ. 2013;13:a. doi: 10.1186/1472-6920-13-30. doi: 10.1186/1472-6920-13-30.
    1. Kanthan R. The impact of specially designed digital games-based learning in undergraduate pathology and medical education. Arch Pathol Lab Med. 2011:135. doi: 10.1043/2009-0698-OAR1.1. doi: 10.1016/j.ypat.2011.08.024.

Source: PubMed

Sponsors et collaborateurs

Les conditions médicales

Interventions en matière de drogue

3
S'abonner