PC3107: Use of Electronic Text Messaging of NRP Principles to Pediatric Trainees and Impact on Retention

Background: Pediatric trainees have limited Neonatal Intensive Care Unit (NICU) experience and fewer opportunities to attend deliveries and master the skills needed to resuscitate newborns. The purpose of our study was to provide distance learning via text messaging of Neonatal Resuscitation Program (NRP) 8th edition principles and assess knowledge, retention, confidence, and integration of skills among Pediatrics residents.

Methods: This was a randomized controlled, prospective study including Pediatrics and Medicine-Pediatrics residents. A baseline survey and quiz assessed knowledge and confidence in neonatal resuscitation. Intervention group received biweekly NRP content pearls (Image 1) for 6-weeks. Subsequently, both groups completed a 6-week quiz followed by a 6-week period of no contact. Participants completed a 12-week quiz to assess knowledge retention. Two high fidelity simulations were completed by participants and scored using a validated tool. Data was analyzed using SPSS software.

Results: Of the 20 participants, 16 were Pediatrics and 4 were Medicine-Pediatrics residents. Majority needed more knowledge and were not confident in leading a neonatal resuscitation. Baseline quiz median score for the groups were relatively the same and the 6-week median quiz score for the intervention group was 5% higher; however, not statistically significant. The 12-week median quiz score was the same for both groups, which suggests that text messaging does not improve retention of NRP knowledge, again not statistically significant. Simulation scores for both scenarios, term and premature infant, were higher for the intervention group; however, not statistically significant. (Table 1a) Further breakdown of the term infant simulation showed that the control group scored significantly higher with the hands-on application of bag/mask ventilation, and the intervention group scored higher for intubation. (Table 1b) There was no difference for the premature infant simulation breakdown. This suggests that text messaging of NRP content does not necessarily translate to improved hands-on application of the individual resuscitation maneuvers. Final survey showed increased confidence in leading an NRP resuscitation for the intervention group.

Conclusion: We conclude that text messaging did not improve knowledge or retention of NRP content for pediatric trainees; however, our study had many limitations, especially a small sample size. Confidence in leading an NRP resuscitation did increase. Future directions involve repeating the study with a larger number of trainees.