Neonatal Display Project
Neonatal resuscitation teams have a significant number of data streams to perceive, comprehend, process, and act upon to provide safe, efficient, and effective patient care. Cognitive workload during resuscitation can be excessive and limit situational awareness and team performance. Methods for achieving optimal cognitive workload and performance have been largely unexplored in healthcare, but well established in other high- risk industries. The goal of this study is to understand the cognitive workload, gaze patterns, and behavioral performance of healthcare professionals during simulated neonatal resuscitation.
Neonatal Display Project II
Approximately 10% of newborns require some level of assistance, such as resuscitation, to begin breathing at birth. A crucial aspect of resuscitation is ensuring that newly born infants receive sufficient oxygen. When the infant’s blood oxygen saturation is below target levels based on time after delivery, supplemental oxygen must be delivered with assisted ventilation. The concentration of supplemental oxygen should be adjusted throughout resuscitation to meet these targets without excessively oxygenating the infant, which may result in tissue and organ injury. Thus, the care provider needs to monitor the infant’s measured blood oxygen saturation, cross-reference it with the target levels, and adjust oxygen supplementation accordingly.
We are exploring design concepts for a neonatal data display to make oxygen supplementation easier and more intuitive, in order to reduce the cognitive load of this task for care providers during resuscitation. Currently, we are using simulation scenarios and eye tracking to evaluate the efficacy and behavioral consequences of introducing a graphical display of oxygen saturation targets with real-time data for at-a-glance visualization of oxygenation trends during resuscitation.
The American Academy of Pediatrics (AAP) Neonatal Resuscitation Program (NRP) course is designed to teach neonatal resuscitation guidelines to healthcare providers who care for newborns at birth. Healthcare providers who manage newborns at hospital births are required to participate in NRP every two years. However, previous studies show there is a rapid decline in skill retention after only 6 months. NRP electronic simulation (eSim) is an independent, computer-based simulation program that allows providers to practice the NRP steps in an online environment. A demo version can be accessed here. NRP eSim can be done individually on the learner's own schedule, without the need for faculty mentoring, and is ideal for episodic learning. This is particularly important when institutional resources are limited for refresher training. It is not known whether either NRP eSim or video review is effective in preventing the known deterioration in NRP skills. In this multi-site study, our objective is to investigate the effectiveness of NRP eSim on episodic learning and retention for providers who are learning how to perform resuscitation.