Effect of repeat refresher courses on neonatal resuscitation skill decay: an experimental comparative study of in-person and video-based simulation training

Abstract

Neonatal deaths are a major contributor to global under-5-year-old mortality. Training birth attendants can improve perinatal outcomes, but skills may fade over time. In this pilot study, we assessed skill decay of nursing students after remote video versus in-person resuscitation training in a low-resource setting. Filipino nursing students (n = 49) underwent traditional, in-person simulation-based Helping Babies Breathe (HBB) training in Mindanao, Philippines. Participants were then assigned to receive refresher training at 2-month intervals either in-person or via tele-simulation beginning at 2 months, 4 months, or 6 months after initial training. A knowledge examination and practical examination, also known as objective structured clinical examination B in the HBB curriculum, were administered before retraining to assess knowledge and skill retention at time of scheduled follow-up. Time to initiation of bag-mask ventilation (BMV) in seconds during simulated birth asphyxia was the primary outcome. Skill decay was evident at first follow-up, with average time to BMV increasing from 56.9 (range 15–87) s at initial post-training to 83.8 (range 32–128) s at 2 months and 90.2 (range 51–180) s at 4 months. At second follow-up of the 2-month group, students showed improved pre-training time to BMV (average 70.4; range 46–97 s). No statistical difference was observed between in-person and video-trained students in time to BMV. Because of COVID-19 restrictions, the 6-month follow-up was not completed. We conclude that remote video refresher training is a reasonable alternative to traditional in-person HBB training. Our study also suggests that refreshers may be needed more frequently than every 2 months to mitigate skill decay. Additional studies are necessary to assess the longitudinal impact of tele-simulation on clinical outcomes.

Cross‐sectional study in Madagascar demonstrates efficacy of virtual mentoring and flipped classroom modifications of neonatal resuscitation programme Helping Babies Breathe

“…In a study performed in Guatemala City, in person facilitators were guided by a US‐based master trainer via video conferencing to successfully provide HBB training 6 . Another study in the Philippines found that the Facebook messenger video‐based platform provided sufficient oversight to assess skill acquisition of participants during follow‐up refresher trainings 7 . Such studies were similarly virtually mentored.…”

“…This study assessed the viability of a virtually mentored dissemination of this training. While similar studies have taken place in the United States, Guatemala and the Philippines, to the best of our knowledge virtually mentored HBB training has not yet been studied in Africa 5–7 …”

“…6 Another study in the Philippines found that the Facebook messenger video-based platform provided sufficient oversight to assess skill acquisition of participants during follow-up refresher trainings. 7 Such studies were similarly virtually mentored.…”

“…While similar studies have taken place in the United States, Guatemala and the Philippines, to the best of our knowledge virtually mentored HBB training has not yet been studied in Africa. [5][6][7] A fully virtual training was considered. However, didactics without technical training do not lead to increases in technical skill, despite improvements in clinical assessment.…”

Correction: Effect of repeat refresher courses on neonatal resuscitation skill decay: an experimental comparative study of in-person and video-based simulation training

“…The original article [ 1 ] contained a typo in author, Nicole A. Shilkofski's name which has since been amended.…”