303 - DeveLopment of EducationAl Modules for Resuscitation of Neonates in the Delivery Room with Congenital Heart Disease (LEARN-CHD study)

Sunday, April 30, 2023

3:30 PM – 6:00 PM ET

Poster Number: 303
Publication Number: 303.347

Alyssa R. Thomas, Boston Children's Hospital, South Boston, MA, United States; Philip Levy, Boston Children's Hospital, Boston, MA, United States; Brenda H. Law, University of Alberta Faculty of Medicine and Dentistry, Edmonton, AB, Canada; Chloe Joynt, University of Alberta Faculty of Medicine and Dentistry, Edmonton, AB, Canada; Ruby Gupta, Medical College of Wisconsin, Milwaukee, WI, United States; Summer Elshenawy, Emory University School of Medicine, Atlanta, GA, United States; Danielle Reed, Children’s Mercy kansas City, Kansas City, MO, United States; Leeann R. Pavlek, Nationwide Children's Hospital, Columbus, OH, United States; Jennifer Shepherd, Children's Hospital Los Angeles/University of Southern California, Los Angeles, CA, United States; Sharada H. Gowda, Baylor College of Medicine, Houston, TX, United States; Beth Ann Johnson, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Jennifer L. Arnold, Boston Children's Hospital - - Boston, MA, Natick, MA, United States; Molly K. Ball, Nationwide Children's Hospital, Columbus, OH, United States; Noorjahan Ali, University of Texas Southwestern Medical School, Dallas, TX, United States

Presenting Author(s)

Alyssa R. Thomas, MD (she/her/hers)

Fellow
Boston Children's Hospital
South Boston, Massachusetts, United States

Background: Unique transitional pathophysiology of critical congenital heart defects (CCHDs) often requires delivery room (DR) management specific to the lesion. Existing neonatal resuscitation guidelines such as the Neonatal Resuscitation Program (NRP) do not include CCHD-specific education or algorithm modifications. There is an urgent need for online learning modules (eLearning) to provide comprehensive education on this topic. They are yet to be designed or tested.

Objective: Developed eLearning modules on CCHD DR management to supplement NRP guidelines and tested their feasibility and efficacy using knowledge assessment and high-fidelity simulation of CCHD DR scenarios to bridge this knowledge gap.

Design/Methods: In a nested pilot observation study from a larger prospective multicenter study, neonatal and cardiac experts in CCHD, simulation and education designed four eLearning modules with corresponding simulation scenarios covering specific CCHD pathophysiology and DR management. Multidisciplinary NRP-certified providers were recruited to study the effect of CCHD specific e-Learning modules vs. directed CCHD article readings. Teams of three (nurse, respiratory therapist, physician) were 1) randomized to study modules or control review articles, 2) participated in one traditional NRP placental abruption and three DR CCHD management simulations. The primary feasibility outcome was completion of simulations; secondary outcomes included participant surveys of workload, perceived stress and knowledge acquisition.

Results: This pilot was completed at Boston Children’s Hospital with 3 teams; 2 received eLearning modules and 1 read CCHD review articles. All teams successfully completed the simulations. Of those receiving eLearning modules, participants strongly agreed they would use the education in future DR efforts and 5/6 agreed that materials could be understood without an extensive cardiac background. Post-simulation, participants reported moderate mental demand (median score 5/10; 10 = very demanding, range 1-9) and low frustration level with task performance (median score 1/10; 10 = very frustrated, range 1-4). Video review of pilot simulations ensured agreement between module teaching goals, simulation scenarios and scoring protocol and increased scoring concordance among reviewers.

Conclusion(s):

This pilot study developed consensus-based eLearning modules guiding CCHD DR management and demonstrated their feasibility and acceptability. In Phase 2 we will study the effect of CCHD specific e-Learning modules vs. directed CCHD article readings in a randomized control study across 12 centers nationwide.