P3.230: Impact of Rapid Cycle Deliberate Practice on Neonatal Resuscitation Program Knowledge and Skill Retention in the Emergency Department

Background: In settings such as the emergency room, correctly-performed resuscitation immediately after delivery is crucial for increased chances of survival in neonates. However, in high-acuity, low-occurrence events like neonatal resuscitation, retention of knowledge and skills declines rapidly after training. This study aims to evaluate the effect of training via Rapid Cycle Deliberate Practice (RCDP) as compared to standard post-simulation debriefing on short-term and long-term retention of Neonatal Resuscitation Program (NRP) knowledge and skills in emergency medicine residents, up to 6 months.

Methods: This is a prospective randomized controlled study in the Emergency Department at Level I Trauma Center. Thirty-nine Emergency Medicine residents (PGY 2 and PGY 4) with no prior NRP certification were randomized into an intervention and control group, where the intervention group was taught via RCDP and the control group was taught using post-simulation debriefing. Participants completed a one-week follow up quiz based on the 8th Edition NRP Principles. After three months, participants completed another follow-up quiz and a simulation, graded by a validated scoring tool from van der Heide et al. After six months, participants completed one final follow-up quiz and simulation. Demographics and clinical characteristics are described, stratified by study group, using mean and standard deviation or count with frequency. We calculated the percent correct for knowledge surveys and tested for differences by group using the Wilcoxon Rank Sum test. All Likert scale and categorical variables were analyzed using Fisher’s Exact test. No adjustments were made for multiple comparisons.

Results: In terms of individual quiz question performance, there was no significant difference between groups on the 3 month quiz and on the 6 month quiz. The results of 1 week follow-up quiz, however, did show that those in the traditional group performed significantly better on a question about managing bradycardia (p = 0.01). The intervention group performed better on a question about the best heart rate assessment method (p = 0.05), with the difference approaching significance.

Conclusion: Limitations of this study include a small sample size, variability in whether the quiz was completed on time as intended, and the ability of participants to look up answers on the internet. In the future, we would like to increase our sample size by expanding our study to PGY 1 and PGY 3 residents, while also better controlling the environment in which the quiz is taken. Data analysis of simulation performance at 3 and 6 months is ongoing.