Curriculum and assessment tool for less invasive surfactant administration: an international Delphi consensus study

Niklas Breindahl; Martin G Tolsgaard; Tine B Henriksen; Charles C Roehr; Tomasz Szczapa; Luigi Gagliardi; Maximo Vento; Ragnhild Støen; Kajsa Bohlin; Anton H van Kaam; Daniel Klotz; Xavier Durrmeyer; Tongyan Han; Anup C Katheria; Peter A Dargaville; Lise Aunsholt

doi:10.1038/s41390-023-02621-2

Curriculum and assessment tool for less invasive surfactant administration: an international Delphi consensus study

Pediatr Res. 2023 Sep;94(3):1216-1224. doi: 10.1038/s41390-023-02621-2. Epub 2023 May 4.

Authors

Niklas Breindahl^{1

2

3}, Martin G Tolsgaard^{4

5

6}, Tine B Henriksen^{7

8}, Charles C Roehr^{9

10}, Tomasz Szczapa¹¹, Luigi Gagliardi¹², Maximo Vento¹³, Ragnhild Støen^{14

15}, Kajsa Bohlin¹⁶, Anton H van Kaam¹⁷, Daniel Klotz¹⁸, Xavier Durrmeyer^{19

20}, Tongyan Han²¹, Anup C Katheria²², Peter A Dargaville²³, Lise Aunsholt^{24

5

25}

Affiliations

¹ Department of Neonatal and Pediatric Intensive Care, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark. Niklas.breindahl@gmail.com.
² Copenhagen Academy for Medical Education and Simulation (CAMES), Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark. Niklas.breindahl@gmail.com.
³ Prehospital Center Region Zealand, Næstved, Denmark. Niklas.breindahl@gmail.com.
⁴ Copenhagen Academy for Medical Education and Simulation (CAMES), Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
⁵ Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
⁶ Department of Obstetrics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
⁷ Department of Paediatrics (Intensive Care Neonatology), Aarhus University Hospital, Aarhus, Denmark.
⁸ Perinatal Research Unit, Clinical Institute, Aarhus University, Aarhus, Denmark.
⁹ Newborn Services, Southmead Hospital, North Bristol NHS Trust Bristol, Bristol, UK.
¹⁰ Nuffield Department of Population Health, National Perinatal Epidemiology Unit, Medical Sciences Division, University of Oxford, Oxford, UK.
¹¹ 2nd Department of Neonatology, Neonatal Biophysical Monitoring and Cardiopulmonary Therapies Research Unit, Poznan University of Medical Sciences, Poznan, Poland.
¹² Division of Neonatology and Pediatrics, Ospedale Versilia, Viareggio, Azienda USL Toscana Nord Ovest, Pisa, Italy.
¹³ Division of Neonatology, University and Polytechnic Hospital La Fe (HULAFE) and Health Research Institute (IISLAFE), Valencia, Spain.
¹⁴ Department of Neonatology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
¹⁵ Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
¹⁶ Department of Neonatology, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden.
¹⁷ Department of Neonatology, Emma Children's Hospital Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
¹⁸ Center for Pediatrics, Division of Neonatology and Pediatric Intensive Care Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
¹⁹ Department of Neonatal Intensive Care and Neonatology, Centre Hospitalier Intercommunal de Créteil, Université Paris Est Créteil, Créteil, France.
²⁰ GRC CARMAS, IMRB, Université Paris Est Créteil, Faculté de Santé de Créteil, Créteil, France.
²¹ Department of Pediatrics, Peking University Third Hospital, Beijing, China.
²² Neonatal Research Institute, Sharp Mary Birch Hospital for Women & Newborns, San Diego, CA, 92123, USA.
²³ Department of Paediatrics, Royal Hobart Hospital, Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.
²⁴ Department of Neonatal and Pediatric Intensive Care, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
²⁵ Department of Veterinary and Animal Science, University of Copenhagen, Copenhagen, Denmark.

Abstract

Background: Training and assessment of operator competence for the less invasive surfactant administration (LISA) procedure vary. This study aimed to obtain international expert consensus on LISA training (LISA curriculum (LISA-CUR)) and assessment (LISA assessment tool (LISA-AT)).

Methods: From February to July 2022, an international three-round Delphi process gathered opinions from LISA experts (researchers, curriculum developers, and clinical educators) on a list of items to be included in a LISA-CUR and LISA-AT (Round 1). The experts rated the importance of each item (Round 2). Items supported by more than 80% consensus were included. All experts were asked to approve or reject the final LISA-CUR and LISA-AT (Round 3).

Results: A total of 153 experts from 14 countries participated in Round 1, and the response rate for Rounds 2 and 3 was >80%. Round 1 identified 44 items for LISA-CUR and 22 for LISA-AT. Round 2 excluded 15 items for the LISA-CUR and 7 items for the LISA-AT. Round 3 resulted in a strong consensus (99-100%) for the final 29 items for the LISA-CUR and 15 items for the LISA-AT.

Conclusions: This Delphi process established an international consensus on a training curriculum and content evidence for the assessment of LISA competence.

Impact: This international consensus-based expert statement provides content on a curriculum for the less invasive surfactant administration procedure (LISA-CUR) that may be partnered with existing evidence-based strategies to optimize and standardize LISA training in the future. This international consensus-based expert statement also provides content on an assessment tool for the LISA procedure (LISA-AT) that can help to evaluate competence in LISA operators. The proposed LISA-AT enables standardized, continuous feedback and assessment until achieving proficiency.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Clinical Competence*
Consensus
Curriculum
Delphi Technique
Surface-Active Agents*

Substances

Surface-Active Agents