Presenting video recordings of newborn resuscitations in debriefings for teamwork training.

BACKGROUND The Neonatal Resuscitation Program (NRP) and similar courses have been used to train clinicians. However, formal teamwork training was not included in these courses, and their effectiveness has been questioned. In adult resuscitation, debriefings using video recordings have improved outcomes, but recordings of neonatal resuscitation have been used primarily for research. AIMS To test if debriefings that include video recordings of neonatal resuscitations can improve teamwork and clinical practice. METHODS Over 9 months, clinicians voluntarily attended weekly debriefings in which recently performed resuscitations were presented, evaluated and then discussed. Discussions were focused on teamwork and were facilitated by an education nurse and a human factors expert with a training background. Subsequently, three experts, a neonatologist, a neonatal nurse educator and a midwifery educator from different organisations viewed and scored 19 recordings from the first 4.5 months and 19 recordings from the second 4.5 months. Experts were blinded to the recording period. The two sets of recordings were balanced for babies' gestation and birth weight. Scoring included 'teamwork' items, 'following guidelines' items and 'temporal control of the resuscitation procedure' items. RESULTS All 'teamwork' items improved between the two periods and one item improved significantly (p<0.05). Scores for 'Following guidelines' showed little change except 'Intubation' which deteriorated (p<0.05). There was no significant interaction between periods and raters. Cronbach's alpha indicated inter-expert rating consistency ranging from 0.54 to 0.86. CONCLUSIONS Voluntary debriefings had some positive effect on neonatal resuscitation teamwork. Future studies are warranted to determine the best methods for debriefing combined with other training methods.