Download PDF
Am J Perinatol 2023; 40(06): 624-629
DOI: 10.1055/s-0041-1730361
Original Article

Examining the Validity of Pediatric Resident Self-Assessment in the Delivery Room

Betté S. Ford
1   Division of Neonatology, Connecticut Children's, Hartford, Connecticut
2   Department of Pediatrics, University of Connecticut School of Medicine, Farmington, Connecticut
,
James I. Hagadorn
1   Division of Neonatology, Connecticut Children's, Hartford, Connecticut
2   Department of Pediatrics, University of Connecticut School of Medicine, Farmington, Connecticut
,
Jennifer M. Trzaski
1   Division of Neonatology, Connecticut Children's, Hartford, Connecticut
2   Department of Pediatrics, University of Connecticut School of Medicine, Farmington, Connecticut
› Author Affiliations Funding None.
› Further Information
    Permissions and Reprints

Abstract

Objective The validity of resident self-assessment of competence in neonatal resuscitation skills has not been studied. This study was designed to test the hypothesis that residents are accurate in self-assessment of basic delivery room resuscitation and bag-and-mask ventilation (BMV) skills by comparing resident self-assessed performance with assessment by observers.

Study Design We conducted a prospective repeated measures observational study. After each delivery residents and observers completed 13-question standardized assessments evaluating resident performance.

Results A total of 99 paired assessments were completed by 36 residents. Residents competently performed and identified correct versus incorrect performance of basic resuscitation steps. Residents were less competent in recognizing the need for BMV and were unable to self-assess BMV-associated performance accurately. In multivariable analysis, only basic resuscitation steps versus BMV were significantly associated with accurate self-assessment.

Conclusion Pediatric residents are less competent at performing advanced neonatal resuscitation skills and are unable to accurately self-assess performance of skills essential for neonatal resuscitation.

Key Points

  • Pediatric residents can competently identify and perform basic neonatal resuscitation steps.

  • Pediatric residents are less competent at performing advanced neonatal resuscitation skills.

  • Self-assessment is not a valid method for determining resident competence in neonatal resuscitation.

Keywords

neonatal resuscitation - bag-and-mask ventilation - self-assessment - procedural competence and confidence - validity - pediatric residents

Authors' Contributions

B.S.F. performed data analysis and drafted and revised the manuscript. J.M.T. and J.I.H. supervised and performed data analysis and reviewed and revised the manuscript. All authors conceptualized and contributed to the design of the study, interpreted the results of the analysis, approved the manuscript as submitted, and agreed to be accountable for all aspects of the work.


Supplementary Material



Publication History

Received: 19 December 2020

Accepted: 09 April 2021

Article published online:
31 May 2021

© 2021. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Barber CA, Wyckoff MH. Use and efficacy of endotracheal versus intravenous epinephrine during neonatal cardiopulmonary resuscitation in the delivery room. Pediatrics 2006; 118 (03) 1028-1034
    CrossrefPubMedGoogle Scholar
  • 2 Perlman JM, Wyllie J, Kattwinkel J. et al; Neonatal Resuscitation Chapter Collaborators. Part 7: Neonatal resuscitation: 2015 international consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations. Circulation 2015; 132 (16, suppl 1): S204-S241
    CrossrefPubMedGoogle Scholar
  • 3 Poynter S, Calaman S. McNeal k, Barone M, General Pediatrics EPA Curricular Elements workshop. American Board of Pediatrics: curricular components for general pediatrics EPA 17 2013. Accessed 2013 at: https://www.abp.org/entrustable-professional-activities-epas
    PubMedGoogle Scholar
  • 4 Accreditation Council for Graduate Medical Education (ACGME). ACGME program requirements for graduate medical education in pediatrics. Chicago, IL: Accreditation Council for Graduate Medical Education; . Accessed 2019 at: https://www.acgme.org/Portals/0/PFAssets/ProgramRequirements/320_Pediatrics_2020.pdf?ver=2020-06-29-162726-647
    Google Scholar
  • 5 Nadel FM, Lavelle JM, Fein JA, Giardino AP, Decker JM, Durbin DR. Assessing pediatric senior residents' training in resuscitation: fund of knowledge, technical skills, and perception of confidence. Pediatr Emerg Care 2000; 16 (02) 73-76
    CrossrefPubMedGoogle Scholar
  • 6 Gozzo YF, Cummings CL, Chapman RL, Bizzarro MJ, Mercurio MR. Who is performing medical procedures in the neonatal intensive care unit?. J Perinatol 2011; 31 (03) 206-211
    CrossrefPubMedGoogle Scholar
  • 7 Lee HC, Chitkara R, Halamek LP, Hintz SR. A national survey of pediatric residents and delivery room training experience. J Pediatr 2010; 157 (01) 158-161.e3
    CrossrefPubMedGoogle Scholar
  • 8 Barry JS, Gibbs MD, Rosenberg AA. A delivery room-focused education and deliberate practice can improve pediatric resident resuscitation training. J Perinatol 2012; 32 (12) 920-926
    CrossrefPubMedGoogle Scholar
  • 9 Schumacher DJ, Frintner MP, Cull W. Graduating pediatric resident reports on procedural training and preparation. Acad Pediatr 2018; 18 (01) 73-78
    CrossrefPubMedGoogle Scholar
  • 10 Starr M, Sawyer T, Jones M, Batra M, McPhillips H. A simulation-based quality improvement approach to improve pediatric resident competency with required procedures. Cureus 2017; 9 (06) e1307
    PubMedGoogle Scholar
  • 11 Augustine EM, Kahana M. Effect of procedure simulation workshops on resident procedural confidence and competence. J Grad Med Educ 2012; 4 (04) 479-485
    CrossrefPubMedGoogle Scholar
  • 12 Weiner GM, Zaichkin J. eds. Textbook of Neonatal Resuscitation. 7th ed.. Elk Grove Village, IL: American Academy of Pediatrics; 2016
    CrossrefGoogle Scholar
  • 13 The jamovi project. Jamovi (version 1.2) [computer software]. Accessed 2020 at: https://www.jamovi.org
    PubMedGoogle Scholar
  • 14 Gallucci M. GAMLj: general analyses for linear models [jamovi module]. Accessed 2019 at: https://gamlj.github.io/
    PubMedGoogle Scholar
  • 15 American Board of Medical Specialities. Maintenance of certification competencies and criteria. Accessed 2016 at: http://www.abms.org/maintenanc_of_certification/MOC_competencies.aspx
    PubMedGoogle Scholar
  • 16 Accreditation Council of Graduate Medical Education (ACGME). Milestones guidebook for residents and fellows. Accessed 2020 at: https://www.acgme.org/Portals/0/PDFs/Milestones/MilestonesGuidebookforResidentsFellows.pdf?ver=2020-05-08-150234-750
    PubMedGoogle Scholar
  • 17 Davis DA, Mazmanian PE, Fordis M, Van Harrison R, Thorpe KE, Perrier L. Accuracy of physician self-assessment compared with observed measures of competence: a systematic review. JAMA 2006; 296 (09) 1094-1102
    CrossrefPubMedGoogle Scholar
  • 18 Jethwa AR, Perdoni CJ, Kelly EA, Yueh B, Levine SC, Adams ME. Randomized controlled pilot study of video self-assessment for resident mastoidectomy training. OTO Open 2018;2(02). Doi: 2473974X18770417
    PubMedGoogle Scholar
  • 19 Isenberg GA, Roy V, Veloski J, Berg K, Yeo CJ. Evaluation of the validity of medical students' self-assessments of proficiency in clinical simulations. J Surg Res 2015; 193 (02) 554-559
    CrossrefPubMedGoogle Scholar
  • 20 Karpen SC. The social psychology of biased self-assessment. Am J Pharm Educ 2018; 82 (05) 6299
    CrossrefPubMedGoogle Scholar
  • 21 Panjwani S. Underestimation in self-assessment. Am J Pharm Educ 2019; 83 (05) 7353
    CrossrefPubMedGoogle Scholar
  • 22 Keister DM, Hansen SE, Dostal J. Teaching resident self-assessment through triangulation of faculty and patient feedback. Teach Learn Med 2017; 29 (01) 25-30
    CrossrefPubMedGoogle Scholar
  • 23 Hadid S. Factors influencing nursing student self-assessment in relation to instructor assessment. J Nurs Educ 2017; 56 (02) 70-76
    CrossrefPubMedGoogle Scholar
  • 24 Kruger J, Dunning D. Unskilled and unaware of it: how difficulties in recognizing one's own incompetence lead to inflated self-assessments. J Pers Soc Psychol 1999; 77 (06) 1121-1134
    CrossrefPubMedGoogle Scholar
  • 25 Siegesmund A. Using self-assessment to develop metacognition and self-regulated learners, FEMS Microbiol Lett. 2017 364, 11
    PubMedGoogle Scholar
  • 26 Chow I, Nguyen VT, Losee JE. et al. Milestones in plastic surgery: attending assessment versus resident assessment. Plast Reconstr Surg 2018
    PubMedGoogle Scholar