A Customizable Digital Cognitive Aid for Neonatal Resuscitation: A Simulation-Based Randomized Controlled Trial

Area of Science:

• Medical Education
• Neonatal Resuscitation
• Clinical Simulation

Background:

• Effective management of critically ill neonates relies on adherence to resuscitation algorithms.
• The International Liaison Committee on Resuscitation (ILCOR) provides evidence-based guidelines for neonatal care.
• Junior trainees require optimized tools to enhance performance during critical events.

Purpose of the Study:

• To evaluate the impact of a customizable digital cognitive aid (DCA) versus a standard poster cognitive aid (SOC) on trainee performance.
• To assess technical and nontechnical skills during a simulated neonatal birth event.
• To compare a DCA adapted from 2020 ILCOR recommendations with the current standard of care.

Main Methods:

• A prospective, bicentric, randomized controlled trial involving 108 junior trainees (pediatric residents and midwife students).
• Participants were randomized into groups to use either a DCA with an ILCOR poster or only an ILCOR poster (SOC).
• Performance was assessed via video recording of simulated neonatal cardiac arrest scenarios, scoring technical and nontechnical skills.

Main Results:

• The DCA group demonstrated significantly higher technical scores (P < 0.001) compared to the SOC group.
• Average technical scores were 24.0/27 for the DCA group versus 20.8/27 for the SOC group.
• No significant difference was observed in nontechnical skills scores between the groups; trainee feedback was positive.

Conclusions:

• A digital cognitive aid significantly enhances technical performance in junior trainees during simulated neonatal resuscitation.
• The DCA, based on ILCOR guidelines, offers an advantage over traditional poster algorithms for critical neonatal events.
• Further integration of digital tools in medical education may improve clinical skills acquisition.