The development and testing of a performance checklist to assess neonatal resuscitation megacode skill

The purpose of this work was to develop and assess the feasibility, reliability, and validity of a brief performance checklist to evaluate skills during a simulated neonatal resuscitation ("megacode") for the Neonatal Resuscitation Program of the American Academy of Pediatrics.

A performance checklist of items was created, validated, and modified in sequential phases involving: an expert committee, review, and feedback by Neonatal Resuscitation Program instructors for feasibility and criticality and use of the performance checklist by Neonatal Resuscitation Program instructors reviewing videotaped megacodes. The final 20-item performance checklist used a 3-point scale and was assessed by student and instructor volunteers. Megacode scores, the NRP multiple-choice examination scores, student assessments of their ability and performance, and sociodemographic descriptors for both students and instructors were collected. Data were analyzed descriptively. In addition, we assessed the megacode score internal consistency reliability, the correlations between megacode and multiple-choice examination scores, and the variance in scores based on instructor and student characteristics.

A total of 468 students and 148 instructors volunteered for the study. The instrument was reliable and internally consistent. Student's scores were high on most items. There was a significant but low correlation between the megacode score and the written knowledge examination. Instructor and student characteristics had little effect on the variance in scores.

This performance checklist provides a feasible assessment tool. There is evidence for its reliability and validity.