Non-technical skill performance during remote, international, augmented-reality neonatal resuscitation protocol...

Area of Science:

• Medical Simulation
• Global Health Education
• Augmented Reality in Medicine

Background:

• Neonatal resuscitation training necessitates proficiency in both technical and non-technical skills (NTS).
• The Neonatal Resuscitation Program (NRP) curriculum integrates leadership, teamwork, and situational awareness.
• Simulation-based education is crucial for NTS but faces accessibility challenges in low-resource regions; augmented reality (AR) presents a scalable, remote alternative.

Purpose of the Study:

• To evaluate the feasibility of remote AR medical simulation for assessing NTS during neonatal resuscitation.
• To determine the efficacy of AR in delivering NTS training across international medical institutions.

Main Methods:

• A prospective, single-arm feasibility study was conducted with pediatric and anesthesiology residents in Santiago, Chile, remotely guided by instructors in California.
• Neonatal resuscitation scenarios were delivered via an AR medical simulator.
• Non-technical skills performance was assessed using the Anesthetists' Non-Technical Skills (ANTS) tool and Behaviorally Anchored Rating Scale (BARS), alongside system usability (SUS) and ergonomics evaluations.

Main Results:

• Participants achieved adequate NTS performance, with ANTS scores ranging from 2.5-2.9 and BARS scores from 5.2-5.4 (on scales of 1-4 and 1-9, respectively).
• Performance metrics were comparable to traditional, in-person simulation-based training.
• The AR system demonstrated high usability and minimal ergonomic burden.

Conclusions:

• Remote, international AR neonatal resuscitation simulations are feasible for assessing measurable NTS performance.
• This approach validates AR as a viable tool for global NTS medical education, addressing logistical barriers.