Relationship Between Self-efficacy and Performance of Simulated Neonatal Chest Compressions and Ventilation

INTRODUCTION: Because improved competence in caring for patients is difficult to measure, self-efficacy (the strength of one's belief in one's ability to complete a task) is often used as a surrogate measurement of clinical ability. However, studies in adults and children have shown at best only weak correlations between self-efficacy and performance. This correlation has not been well studied in neonatal resuscitation limiting the utility of self-efficacy as a measurement of the effectiveness of interventions in this population. The objective of this study was to determine whether self-efficacy correlates with performance of simulated neonatal chest compressions and ventilation. METHODS: Sixty-nine neonatal fellows, neonatal nurse practitioners, neonatologists, and nurses completed a 7-point Likert scale in which they reported their ability to perform ventilations and chest compressions. The participants then performed chest compressions and bag-valve-mask ventilation on a mannequin. The performance of participants was compared with the rating of their ability using Spearman rank correlation coefficient. RESULTS: There was no correlation between participants' self-assessment and performance of chest compressions (rs = 0.003) or bag-valve-mask ventilation (rs = 0.08). There was a correlation between experience (years of neonatal intensive care unit experience, number of mock codes, and number of real codes) and the ratings of self-efficacy as well as between the number of mock codes and ventilation performance. CONCLUSIONS: In this study, self-reported efficacy had no correlation to clinical skills in neonatal resuscitation; participants both overestimated and underestimated their clinical proficiency. Prior participation in mock codes in the neonatal intensive care unit was the only factor that correlated with resuscitation performance.