Self-directed Video Versus Instructor-based Neonatal Resuscitation Training

The NRP is becoming more and more a self learning program followed by a written test and
practical hands-on evaluation; but the way the practical skills are taught and practiced has
not been uniformly determined.

The current strategies for teaching involve resuscitation instructors. There are several
difficulties in the developing world to achieve the objective of having a provider trained in
neonatal resuscitation in every delivery. Part of this problem is due to the lack of
instructors and-or budget constraint in addition to logistic difficulties.

Our Hypothesis is that a well developed self administered video complemented by a self
practice using a mannequin will allow providers to reach at least similar performances on the
initial steps and mask ventilation for neonatal resuscitation.

Objectives:

The aim of this study is to test the hypothesis that a self administrated video jointly with
a mannequin give similar results than the current Neonatal Resuscitation Program (NRP), a
pre-validated Objective Structured Clinical Examination (OSCE)hands-on course provided by a
certified instructor.

Specific aim:

To compare the effectiveness of two different teaching strategies on the quality of the
ventilation of a mannequin, using a mask by NAÏVE providers. In two different moments,
approximately 15 minutes after having taken the course and at a mean of 3 months afterwards.

Two different groups of novice providers will be randomly selected to receive one of the
following teaching strategies:

A. A Video based Self instruction with simultaneous video triggered practice with a mannequin
without instructor feedback (Spanish in South America, English in North America) on initial
steps and adequate mask ventilation for neonatal resuscitation.

B. A pre standardized hands on lesson will be offered by a NRP certified instructor followed
by a debriefing session per a pre-validated OSCE protocol (current standard).

Afterwards, all the subjects will be invited to ventilate a mannequin with a standardized
instruction (tbd for example…2 minutes ventilation, rate 40 to 60 and the necessary pressure
to slightly reach chest rising). This performance will be digitally recorded.

Two independent certified instructors will evaluate the performance, blinded to the assigned
group. A previously validated OSCE (objective structured clinical evaluation) performance
evaluation grid will be used. The gold standard will consist on a high quality performance
done by an NRP instructor.

Inclusion Criteria:

- Medical Students from second year and above not previously trained in NRP (the
Neonatal Resuscitation Program)

- Nursing Students from second year and above not previously trained in NRP

- Informed consent signed

Exclusion Criteria:

- previous experience in NRP