Format Changes Improve Learner Satisfaction in Local Neonatal Resuscitation Program Skills Education

The Neonatal Resuscitation Program (NRP) is a national education program that prepares learners to resuscitate newborn babies. Our local Texas Children's Hospital (TCH) NRP educational class incorporates skills training and high-fidelity simulations of neonatal resuscitation scenarios. The skills training had four elements we believed were not ideal. 1. Learners went to skills stations in groups, but different teams were formed for performing the scenario simulations in the latter half of the class. 2. The skills stations were visited in random order and not necessarily the actual order in the skills would be performed in a clinical situation. 3. Educational content presented at the skills station was highly variable depending on the instructor. 4. Emphasis was on instructors teaching content over learners practicing and demonstrating skills. In March 2019 we restructured the skills education portion completely to address all four of these problems.

To determine how changes to the design of our skills education affected learner satisfaction with the NRP course.

Using the principles of situated cognition, the skills education was restructured by leadership planning and consensus. We made four changes. 1. Teams were assigned from the beginning of class, and these teams practiced all skills and performed the simulations together. 2. Every team went through the skills stations in the order they would perform them in an actual resuscitation. 3. Videos were made to teach the "gold standard" information needed for the skills stations. 4. Instructors were asked to think of themselves as coaches and not teachers, letting the videos do the education, and they focused on improving skill performance. A survey was designed and disseminated by e-mail to all learners of the first 13 classes taught using the new educational format (n=196). The survey asked learners to compare their experience of the new format compared to their memory of the previous format.

A total of 163 learners responded and completely finished the survey (83% response rate). Of the 163 respondents, 109 learners (67%) had taken the course in the past at TCH and filled out the survey questions comparing the new format to the past format. Out of the total, 93% of learners (n=101) judged the new format to be "better" or "much better." The percentage of learners that attributed the improvement to the changes we made were: 70% for team assignments from the beginning (n=76), 74% for skills performed in order (n=81), 68% for video-based education (n=74), and 76% for instructors as coaches (n=83). Learners rated the videos used for education very highly.

The reformat of our skills education has improved our learners' experience during NRP training. The highest-rated change was asking our instructors to operate as coaches rather than teachers.