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Improving the Effectiveness of
Bag and Mask Ventilation Training
  in an Academic Center NICU

               Jim Barry
     Medical Director, University of
       Colorado Hospital NICU
Background
• BMV is a simple skill that is simply done wrong
  frequently
• Simulation and Learning (and not forgetting)
  Theory
  – Retrieval based testing/learning improves short and
    long term memory- THE WAY WE TEST MATTERS
  – Partial task trainers and deliberate practice can
    improve skill attainment in trainees (LP)
• Knowledge Gaps
  – Can the combination of deliberate practice and
    retrieval testing improve skill acquisition and retention
    for BMV ?
PICO Question
• Population
  – Primary- 2011- 2012 Pediatric Residents from Univ Co
  – Secondary- other NICU staff: RNs, RTs, NNPs, MDs
• Intervention
  – Formal training: deliberate practice, knowledge (retrieval vs
    recognition), spacing
• Comparison
  – Subjects in 3 groups varied by testing: Recognition, Retrieval,
    Retrieval+Practice
• Outcome
  – Changes in BMV Knowledge and Skill at 1 month and 6-12
    months later
Approach
• Randomized controlled study
  1. Randomize teams monthly into 1 of 3 study groups
  2. Knowledge evaluation with pre/post-test (Retrieval
     or Recognition) beginning/end of month and 6-12
     months
  3. Pretest, questionnaire to determine BMV experience
     and career choice
  4. Evaluate BMV skill and equipment knowledge with
     video-recorded session using apneic neonatal partial
     task trainer
  5. BMV scoring tool and mastery learning applied
  6. Pre/PostData collected: Knowledge, BMV skill
3 Questions
• What would be the best format/time to evaluate
  long(er) term retention? 3,6,9 months
• Currently at single center, could this be
  replicated at other sites?
• How could this education/intervention be applied
  to patient outcomes?

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Barry bmv alert 2012

  • 1. Improving the Effectiveness of Bag and Mask Ventilation Training in an Academic Center NICU Jim Barry Medical Director, University of Colorado Hospital NICU
  • 2. Background • BMV is a simple skill that is simply done wrong frequently • Simulation and Learning (and not forgetting) Theory – Retrieval based testing/learning improves short and long term memory- THE WAY WE TEST MATTERS – Partial task trainers and deliberate practice can improve skill attainment in trainees (LP) • Knowledge Gaps – Can the combination of deliberate practice and retrieval testing improve skill acquisition and retention for BMV ?
  • 3. PICO Question • Population – Primary- 2011- 2012 Pediatric Residents from Univ Co – Secondary- other NICU staff: RNs, RTs, NNPs, MDs • Intervention – Formal training: deliberate practice, knowledge (retrieval vs recognition), spacing • Comparison – Subjects in 3 groups varied by testing: Recognition, Retrieval, Retrieval+Practice • Outcome – Changes in BMV Knowledge and Skill at 1 month and 6-12 months later
  • 4. Approach • Randomized controlled study 1. Randomize teams monthly into 1 of 3 study groups 2. Knowledge evaluation with pre/post-test (Retrieval or Recognition) beginning/end of month and 6-12 months 3. Pretest, questionnaire to determine BMV experience and career choice 4. Evaluate BMV skill and equipment knowledge with video-recorded session using apneic neonatal partial task trainer 5. BMV scoring tool and mastery learning applied 6. Pre/PostData collected: Knowledge, BMV skill
  • 5. 3 Questions • What would be the best format/time to evaluate long(er) term retention? 3,6,9 months • Currently at single center, could this be replicated at other sites? • How could this education/intervention be applied to patient outcomes?