154 - Rapid Cycle Deliberate Practice: A Teaching Method to Improve Retention of NRP Knowledge and Skills

Publication Number: 4151.154

Mugil V. Shanmugam, Keck School of Medicine of the University of Southern California, Oak Park, CA, United States; Kathleen Tedesco, Keck School of Medicine of the University of Southern California, Los Angeles, CA, United States; Manoj Biniwale, Cedars Sinai Medical Center, Los Angeles, CA, United States; Fiona AGM. Wertheimer, Keck School of Medicine of the University of Southern California, Los Angeles, CA, United States

Background: Neonatal resuscitation skills are valuable for Emergency Medicine providers when faced with high-risk deliveries. Standard practice for Neonatal Resuscitation Program (NRP) training is to provide post-simulation debriefing, however, Rapid Cycle Deliberate Practice (RCDP) may be beneficial when training motivated learners. This technique employs multiple iterations of practice and feedback to emphasize key takeaways.

Objective: We compared NRP training for Emergency Medicine residents using RCDP against post-simulation debriefing to identify which method is more effective for retention of NRP knowledge and skills over time.

Design/Methods: Emergency Medicine residents with no prior NRP certification at a Level 1 Trauma Center were enrolled in this study. Participants were randomly assigned to a control group receiving standard NRP post-simulation debriefing or the intervention RCDP group, stratifying for year of training. Participants completed a pre-survey, the online NRP 8th Edition training module, in-person NRP simulation with debriefing or RCDP, and a post-survey. Retention of knowledge and skills was evaluated by a one-week follow-up quiz, 3-month follow-up quiz with simulation assessment, and 6-month follow-up quiz with simulation assessment. All quizzes were based on 8th Edition NRP Principles. Differences by group were analyzed using Fisher's Exact test and Wilcoxon Rank Sum test.

Results: 54 of 71 (76.1%) total participants completed the one-week follow-up quiz, 43 participants (60.6%) completed the 3-month follow-up quiz, and 22 participants (31.0%) completed the 3-month simulation. The RCDP group received a significantly higher overall score on the one-week follow-up quiz (p < 0.05). They also performed significantly better than the control group in identifying the best method of heart rate assessment (p < 0.01). In the 3-month simulation, the RCDP group accurately identified a need for positive pressure ventilation (PPV) earlier (p < 0.05). No significant differences were observed for the 3-month quiz.

Conclusion(s): Results indicate that teaching NRP via RCDP is feasible and benefits both short and long term retention of NRP 8th Edition knowledge and skills. Better short-term retention of knowledge was achieved by the RCDP group as evidenced by the difference in the one-week follow-up quiz; better long-term retention of skills was demonstrated by the earlier initiation of PPV during simulation. Limitations of this study include participants taking quizzes in different environments as well as a small sample size. Data collection is continuing to see if these results persist at the 6-month follow-up.

Table 1. Significant Results by Group


Table 2. Demographics of the n=71 Pre-Survey Respondents