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Kuijpers LJMK, Binkhorst M, Yamada NK, Bouwmeester RN, van Heijst AFJ, Halamek LP, Hogeveen M. Validation of an Instrument for Real-Time Assessment of Neonatal Intubation Skills: A Randomized Controlled Simulation Study. Am J Perinatol 2022; 39:195-203. [PMID: 32898921 DOI: 10.1055/s-0040-1715530] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
OBJECTIVE This study aimed to evaluate the construct validity and reliability of real-time assessment of a previously developed neonatal intubation scoring instrument (NISI). STUDY DESIGN We performed a randomized controlled simulation study at a simulation-based research and training facility. Twenty-four clinicians experienced in neonatal intubation ("experts") and 11 medical students ("novices") performed two identical elective intubations on a neonatal patient simulator. Subjects were randomly assigned to either the intervention group, receiving predefined feedback between the two intubations, or the control group, receiving no feedback. Using the previously developed NISI, all intubations were assessed, both in real time and remotely on video. Construct validity was evaluated by (1) comparing the intubation performances, expressed as percentage scores, with and without feedback, and (2) correlating the intubation performances with the subjects' level of experience. The intrarater reliability, expressed as intraclass correlation coefficient (ICC), of real-time assessment compared with video-based assessment was determined. RESULTS The intervention group contained 18 subjects, the control group 17. Background characteristics and baseline intubation scores were comparable in both groups. The median (IQR) change in percentage scores between the first and second intubation was significantly different between the intervention and control group (11.6% [4.7-22.8%] vs. 1.4% [0.0-5.7%], respectively; p = 0.013). The 95% CI for this 10.2% difference was 2.2 to 21.4%. The subjects' experience level correlated significantly with their percentage scores (Spearman's R = 0.70; p <0.01). ICC's were 0.95 (95% CI: 0.89-0.97) and 0.94 (95% CI: 0.89-0.97) for the first and second intubation, respectively. CONCLUSION Our NISI has construct validity and is reliable for real-time assessment. KEY POINTS · Our neonatal intubation scoring instrument has construct validity.. · Our instrument can be reliably employed to assess neonatal intubation skills directly in real time.. · It is suitable for formative assessment, i.e., providing direct feedback during procedural training..
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Affiliation(s)
- Lindie J M K Kuijpers
- Department of Neonatology, Radboud University Medical Center Amalia Children's Hospital, Nijmegen, The Netherlands
| | - Mathijs Binkhorst
- Department of Neonatology, Radboud University Medical Center Amalia Children's Hospital, Nijmegen, The Netherlands
| | - Nicole K Yamada
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Center for Advanced Pediatric and Perinatal Education (CAPE), Stanford University School of Medicine, Palo Alto, California
| | - Romy N Bouwmeester
- Department of Neonatology, Radboud University Medical Center Amalia Children's Hospital, Nijmegen, The Netherlands
| | - Arno F J van Heijst
- Department of Neonatology, Radboud University Medical Center Amalia Children's Hospital, Nijmegen, The Netherlands
| | - Louis P Halamek
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Center for Advanced Pediatric and Perinatal Education (CAPE), Stanford University School of Medicine, Palo Alto, California
| | - Marije Hogeveen
- Department of Neonatology, Radboud University Medical Center Amalia Children's Hospital, Nijmegen, The Netherlands
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Geurtzen R, van Heijst AFJ, Draaisma JMT, Kuijpers LJMK, Woiski M, Scheepers HCJ, van Kaam AH, Oudijk MA, Lafeber HN, Bax CJ, Koper JF, Duin LK, van der Hoeven MA, Kornelisse RF, Duvekot JJ, Andriessen P, van Runnard Heimel PJ, van der Heide-Jalving M, Bekker MN, Mulder-de Tollenaer SM, van Eyck J, Eshuis-Peters E, Graatsma M, Hermens RPMG, Hogeveen M. Development of Nationwide Recommendations to Support Prenatal Counseling in Extreme Prematurity. Pediatrics 2019; 143:peds.2018-3253. [PMID: 31160512 DOI: 10.1542/peds.2018-3253] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/25/2019] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To develop a nationwide, evidence-based framework to support prenatal counseling in extreme prematurity, focusing on organization, decision-making, content, and style aspects. METHODS A nationwide multicenter RAND-modified Delphi method study was performed between November 2016 and December 2017 in the Netherlands. Firstly, recommendations were extracted from literature and previous studies. Secondly, an expert panel (n = 21) with experienced parents, obstetricians, and neonatologists rated the recommendations on importance for inclusion in the framework. Thirdly, ratings were discussed in a consensus meeting. The final set of recommendations was approved and transformed into a framework. RESULTS A total of 101 recommendations on organization, decision-making, content, and style were included in the framework, including tools to support personalization. The most important recommendations regarding organization were to have both parents involved in the counseling with both the neonatologist and obstetrician. The shared decision-making model was recommended for deciding between active support and comfort care. Main recommendations regarding content of conversation were explanation of treatment options, information on survival, risk of permanent consequences, impossibility to predict an individual course, possibility for multiple future decision moments, and a discussion on parental values and standards. It was considered important to avoid jargon, check understanding, and provide a summary. The expert panel, patient organization, and national professional associations (gynecology and pediatrics) approved the framework. CONCLUSIONS A nationwide, evidence-based framework for prenatal counseling in extreme prematurity was developed. It contains recommendations and tools for personalization in the domains of organization, decision-making, content, and style of prenatal counseling.
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Affiliation(s)
| | | | | | | | - Mallory Woiski
- Obstetrics and Gynecology, Amalia Children's Hospital and
| | | | | | - Martijn A Oudijk
- Department of Obstetrics and Gynecology, Amsterdam University Medical Center and University of Amsterdam, Amsterdam, Netherlands
| | | | - Caroline J Bax
- Obstetrics and Gynecology, Vrije Universteit Medical Center and Vrije Universteit Amsterdam, Amsterdam, Netherlands
| | | | - Leonie K Duin
- Obstetrics, Gynecology, and Prenatal Diagnosis, University Medical Center Groningen and University of Groningen, Groningen, Netherlands
| | | | | | - Johannes J Duvekot
- Department of Obstetrics and Gynecology, Erasmus University Medical Center, Rotterdam, Netherlands
| | | | | | | | - Mireille N Bekker
- Obstetrics and Gynecology, Wilhelmina Children's Hospital, University Medical Centre, Utrecht, Netherlands
| | | | - Jim van Eyck
- Obstetrics and Gynecology, Isala Woman and Children's Hospital Zwolle, Zwolle, Netherlands; and
| | - Ellis Eshuis-Peters
- Neonatology, Department of Pediatrics, Leiden University Medical Center, Leiden, Netherlands
| | | | - Rosella P M G Hermens
- Scientific Institute for Quality of Care, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
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