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The Effect of Independent Computer-Based Simulation on Neonatal Resuscitation Skills
Green, Donna A

2017, PhD, University of Cincinnati, Nursing: Nursing - Doctoral Program.
Annually, almost 1 million babies die across the world due to birth asphyxia. In the United States, 400,000 infants will require assistance with breathing and approximately 40,000 infants will require extensive resuscitative measures. Performing neonatal resuscitation accurately is critical to saving these infants’ lives. Integrating various simulation-based opportunities, including independent computer based simulation (CBS), into the adult learning environment provides an approach to assist neonatal healthcare professionals through experiential development, application, and maintenance of their neonatal resuscitation knowledge and skills.
Using a quasi-experimental, longitudinal, pre-test, post-test design, this study examined the effect of independent CBS on performance and retention of neonatal resuscitation concepts of airway, chest compressions, pulse oximetry integration, and communication. The convenience sample (N = 32) included Registered Nurse (RN) participants who are employed at a Mid-Western suburban family birth center that delivers over 2000 babies annually.
Participants were randomly assigned to the control or intervention group. Both groups completed a demographic questionnaire followed by participation in a video taped, neonatal high fidelity simulation (Phase I) for evaluation of baseline knowledge and performance during month 0. During Phase II (month 1) the control group received a clinical update document including neonatal resuscitation steps and processes; the intervention group completed an independent CBS scenario of neonatal resuscitation skills and processes. An evaluation of retention of neonatal resuscitation knowledge occurred in Phase III with the control and intervention groups participating in a second, video taped, neonatal high fidelity simulation for evaluation of performance and retention. Phase I and Phase III simulation performance was scored by two trained experts using an adapted version of the tool “Scoring Tool for Adherence to Neonatal Resuscitation Guidelines “.
A total of 32 participants completed this study. The control group (N = 15) showed sample means (M) and standard deviations (SD’s) of total performance score 70.94 (13.74), 73.13 (10.93) at Phase I and Phase III respectively. The M’s (SD’s) of total performance score were M = 78.94 (9.74) and 78.77 (10.64) respectively in the intervention group (N = 17). The change of the total performance score was (M = -1.06, SD = 12.2) in the intervention group and (M = -1.73, SD = 13.10) in the control group. The difference was not significant between groups (p = 0.881). Overall interpretation is that the impact of independent CBS was not statistically significant in improving performance or retention of neonatal resuscitation skills in either cross-sectional or longitudinal comparisons.
Repeated education on the neonatal resuscitation skills can assist in providing lifesaving care. The healthcare providers must maintain competence in order to rapidly and accurately assess, recollect, act, and analyze the lifesaving interventions needed for compromised neonate. While independent CBS provides reinforcement of neonatal resuscitation concepts, the translation effect in simulation and clinical practice remains undefined. Future research should include interdisciplinary studies with statistical power and larger sample sizes for measurement and evaluation of various resuscitation training strategies, exploration of education cost impact, error reduction approaches, and patient outcomes.
Elaine Miller, Ph.D. (Committee Chair)
Denise Gormley, Ph.D. (Committee Member)
Jun Ying, Ph.D. (Committee Member)
147 p.

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Green, D. (2017). The Effect of Independent Computer-Based Simulation on Neonatal Resuscitation Skills. (Electronic Thesis or Dissertation). Retrieved from

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Green, Donna. "The Effect of Independent Computer-Based Simulation on Neonatal Resuscitation Skills." Electronic Thesis or Dissertation. University of Cincinnati, 2017. OhioLINK Electronic Theses and Dissertations Center. 17 Oct 2018.

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Green, Donna "The Effect of Independent Computer-Based Simulation on Neonatal Resuscitation Skills." Electronic Thesis or Dissertation. University of Cincinnati, 2017.


Full text release has been delayed at the author's request until August 09, 2019