Objective: To examine the hypothesis that an instructor in a remote site can accurately assess the practical skills of a provider performing a simulated neonatal resuscitation (megacode) using videoconferencing.
Methods: Using volunteer NRP providers and instructors, two local telemedicine sites were linked using six telephone lines. Camera angles, sound settings and equipment placement were optimized. Instructors tested providers at the other site. Instructors recorded their observations on checklists based on those of the Neonatal Resuscitation Program (NRP), and all participants completed feedback forms and gave verbal feedback. Based on the results of the pilot study, the protocol and recording tools were developed, and providers at a rural centre were tested. Tests were carried out with local and remote instructors. Observations of local and remote instructors were collected independently, and compared. Opinions of providers were also collected.
Results: Observations of the local and remote instructors on the performances of the providers were consistent; 15 of 18 megacodes reached the required standard. Six telephone lines were required for transmission without noticeable delay in sound transmission. Viewing quality was sufficient for remote instructors to provide feedback on ventilation technique. Providers indicated that videoconferencing did not interfere with their performance and would willingly repeat the experience. Cronbach's alpha for assessment of the technical features was 0.80 or greater for all groups.
Conclusions: Videoconferencing can be used to test resuscitation providers in remote centres. It can enhance neonatal resuscitation education in areas where experienced instructors are in short supply.