TOP 40 - Distinguishing Between Recall and Recognition within Neonatal Resuscitation Program Among Various Provider Groups

Publication Number: 2792.TOP 40

Eric T. Mendenhall, Brody School of Medicine at East Carolina University, Greenville, NC, United States; Alexandra Felix, ECU, Greenville, NC, United States; Dmitry Tumin, East Carolina University Brody School of Medicine, Greenville, NC, United States; Weili Chang, Brody School of Medicine at East Carolina University, Greenville, NC, United States

Background: Ten percent of neonates will require some form of resuscitation, and it is recommended at least one person present at a delivery be able to perform the initial steps of the Neonatal Resuscitation Program (NRP). The current standard of NRP training includes a self-study format that reviews the NRP algorithm followed by multiple-choice questions (MCQs) with unlimited attempts. Learners are then guided through a brief hands-on simulation to complete their training, granting certification for a 2-year period. NRP knowledge decreases over time. Among resident trainees, limited exposure to the Neonatal ICU further reduces application and practice of this knowledge, and this exposure is set to decrease further. This may adversely impact the quality of resuscitative efforts in resource-poor nurseries relying on primary care coverage. While MCQs constitute the primary method of assessing NRP knowledge, real-life resuscitation events are unlike the controlled classroom setting and MCQ scenarios. Performing resuscitation requires recall and occurs during moments of heightened stress. Short answer questions (SAQs), compared to MCQs, are more reflective of recall than simple recognition of material. The degree of NRP knowledge retention (based on recall vs. recognition) has yet to be formally compared across provider groups.

Objective: We used SAQs and MCQs to investigate degrees of NRP knowledge among various provider groups in a single center.

Design/Methods: Assessments were completed by provider groups regularly certified in NRP. NICU nursing staff, Advance Practice Providers, pediatric, medicine/pediatric, and family medicine residents, NICU fellows, and NICU attendings from East Carolina University were enrolled. Data were collected from January to October 2025. Participants were enrolled by convenience sampling, and surveys were distributed to all provider groups via QR code in common work areas and emails. All providers received a 20-question quiz containing 10 SAQs followed by the same 10 questions in MCQ format. SAQs were presented first to avoid priming based on MCQ answer choices. The primary outcome assessed was percentage of correct answers for each topic, comparing performance between SAQs to MCQs on that topic. Additional data included overall percentage of correct MCQs, compared to SAQs. We also be stratified test scores by level of training, experience with code events (real or simulation) and time since last NRP renewal.

Figure 1
Example NRP survey questions in both SAQ and MCQ format. Of note, participants are unable to return to the SAQs while advancing through the survey.

Table 1
All 10 SAQs and MCQs displaying % correct between each question topic.

Table 2
Displays the Average total scores by group out of the 10 SAQs followed by the 10 MCQs.