Impact of the Neonatal Resuscitation Video Review program for neonatal staff: a qualitative analysis

Abstract

Background: Neonatal resuscitation video review (NRVR) involves recording and reviewing resuscitations for education and quality assurance. Though NRVR has been shown to improve teamwork and skill retention, it is not widely used. We evaluated clinicians' experiences of NRVR to understand how NRVR impacts learning and can be improved.

Methods: Neonatal Intensive Care Unit (NICU) clinicians with previous NRVR experience were recruited for individual semi-structured interviews. Using a social constructivist viewpoint, five researchers used thematic analysis to analyze participant responses.

Results: Twenty-two clinicians (11 nurses, 11 doctors) were interviewed. All participants expressed positive attitudes towards NRVR. Four themes were identified: (1) Learning from reality-exposure to real-life resuscitations was highly clinically relevant. (2) Immersive self-regulation-watching videos aided recall and reflection. (3) Complexities in learner psychological safety-all participants acknowledged viewing NRVR videos could be confronting. Some expressed fear of judgment from colleagues, though the educational benefit of NRVR superseded this. (4) Accessing and learning from diverse vantage points-NRVR promoted group discussion, which prompted participant learning from colleagues' viewpoints.

Conclusion: Neonatal clinicians reported NRVR to be an effective and safe method for learning and refining skills required during neonatal resuscitation, such as situational awareness and communication.

Impact: Neonatal resuscitation video review is not known to be widely used in neonatal resuscitation teaching, and published research in this area is limited. Our study examined clinician attitudes towards an established neonatal resuscitation video review program. We found strong support for teaching using neonatal resuscitation video review among neonatal doctors and nurses, with key benefits including increased situational awareness and increased clinical exposure to resuscitations, while maintaining psychological safety for participants. The results of this study add evidence to support the addition of video review to neonatal resuscitation training.

Fig. 1. NRVR camera arrangement and NRVR video stills.

a Resuscitaire with a GoPro camera attached as used to record NRVR videos. b NRVR video of an extremely preterm newborn being supported with a facemask with continuous positive airway pressure after delayed cord clamping, alongside paired physiologic data. c An infant with congenital diaphragmatic hernia who is being intubated before umbilical cord clamping after a vaginal birth. In this example, the mother’s right foot and the screen from the video laryngoscope are visible. The vertical blue line scrolls in time across the graph and correlates physiologic data with the time from birth. Parental consent was provided for the use of these images.

Fig. 2

Kolb’s learning cycle adapted to reflect NRVR, adapted from Kolb.

Fig. 3

Thematic map of participants’ experiences of NRVR.