CE Webinar

Assessing Team Performance in Simulated Neonatal Resuscitation Programs

Presented By:
Leah B Mallory, MD
Sierra Soghikian
neonatal-resucitation-simulation-team-performance
Apr. 10th, 10AM PDT / 1PM EDT
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1 Contact Hour of RN CE
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AI Transcribed Video with Slides
Proficient
1 Hour(s)

This CE webinar will highlight a single measurement tool assessing teamwork in neonatal resuscitation simulations and discuss the changes encountered.
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Abstract:

Neonatal resuscitation is a high-acuity, low-occurrence event that requires ongoing practice by interprofessional teams to maintain proficiency. Neonatal Simulation provides an ideal platform for team training and evaluation of team performance. The simulation center supports a longitudinal in situ simulation training program for delivery room teams. In addition to adherence to the Neonatal Resuscitation Program standards, team performance assessment is an essential component of program evaluation and participant feedback. Multiple published teamwork assessment tools exist. The educator’s objective was to select the tool with the best validity evidence for our program’s needs.

Messick’s framework was used to assess the validity of evidence for potential teamwork assessment tools. Four possible tools were identified from the literature: the Mayo High Performance Teamwork Scale (Mayo), Team Performance Observation Tool (TPOT), Clinical Teamwork Scale (CTS), and Team Emergency Assessment Measure (TEAM). Relevant context included team versus individual focus, external evaluator versus self-evaluation, and ease of use (which included efficiency, clarity of interpretation, and overall assessment). Three simulation experts identified consensus anchors for each tool and independently reviewed and scored 10 pre-recorded neonatal resuscitation simulations. Raters assigned each tool a rating according to efficiency, ease of interpretation, and completeness of teamwork assessment. Interrater reliability (IRR) was calculated using intraclass correlation for each tool across the three raters. Average team performance scores for each tool were correlated with neonatal resuscitation adherence scores for each video, using Spearman’s rank coefficient.

There was a range of IRR between the tools, with Mayo having the best (single 0.55 and multi 0.78). Each of the three raters ranked Mayo optimally in terms of efficiency (mean 4.66 + 0.577) and ease of use (4+1). However, TPOT and CTS scored highest (mean 4.66 ± 0.577) for overall completeness of teamwork assessment. There was no significant correlation to NRP adherence scores for any teamwork tool.

Of the four tools assessed, Mayo demonstrated moderate IRR and scored highest for its ease of use and efficiency, though not completeness of assessment. The remaining three tools had poor IRR, which is not an uncommon problem with teamwork assessment tools. The process emphasizes the fact that assessment tool validity is contextual. Factors such as a relatively narrow (and high) performance distribution and clinical context may have contributed to reliability challenges for tools that offered a more complete teamwork assessment.

Learning Objectives:

  1. Understand the role and importance of neonatal simulation as a tool in the medical field to improve resuscitation outcomes.
  2. Recognize that clinical teamwork is an important skill in multiple medical disciplines such as neonatal resuscitation teams.
  3. Describe the difficulties with validated tool selection to measure institution-specific aspects of teamwork in pediatric simulation experiences.

Meet the Presenter(s):

Leah B Mallory MD
MD Medical Director The Hannaford Center for Safety Simulation and Innovation at Maine Medical Center

As a pediatric hospitalist, Leah enjoys caring for children of all ages – newborn through the late teen years. In addition to her clinical responsibilities, Leah’s academic interests include simulation-based assessment and quality improvement issues in pediatric hospitalist medicine, specifically hospital-to-home transitions. Outside the hospital, she enjoys triathlon training, surfing, and ocean kayaking.

Disclosures: None
Sierra Soghikian Medical Student
Student at Tufts University School of Medicine

Sierra is a third-year medical student at the Tufts University in the Maine Tract. She spent the summer of 2023 participating as the SIM intern, exploring the world of simulation and taking a deep dive into neonatal resuscitation. She is still undecided about speciality but has been drawn to general surgery and OB-GYN. When Sierra is not in the hospital she enjoys ski patrolling at Sunday River and trail running in the White Mountains of New Hampshire.

Disclosures: None

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Teresa Gore PhD, DNP, APRN, FNP-BC, CHSE-A, FSSH, FAAN
Content Manager at HealthySimulation.com
Dr. Gore has experience in educating future nurses in the undergraduate and graduate nursing programs. Dr. Gore has a PhD in Adult Education, a DNP as a family nurse practitioner, and a certificate in Simulation Education. Dr. Gore is an innovative, compassionate educator and an expert in the field of healthcare simulation. In 2007l Teresa started her journey in healthcare simulation. She is involved in INACSL and SSH. She is a Past-President of INACSL and is a Certified Healthcare Simulation Educator Advanced (CHSE-A). In 2018, she was inducted as a Fellow in the American Academy of Nursing (FAAN). In 2021, she was inducted as a Fellow in the Society of Simulation in Healthcare Academy (FSSH) and selected as a Visionary Leader University of Alabama at Birmingham School of Nursing Alumni. During her career, Dr. Gore has led in the development and integration of simulation into all undergraduate clinical courses and started an OSCE program for APRN students. Her research interests and scholarly work focus on simulation, online course development and faculty development. She has numerous invited presentations nationally and internationally on simulation topics.
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