Teaching Helping Babies Breathe via Telehealth: A New Application in Rural Guatemala

Abstract

Background: Helping Babies Breathe (HBB) is a neonatal resuscitation curriculum that teaches life-saving interventions utilized in the first minutes after birth, reducing morbidity and mortality. Traditionally, it requires in-person facilitators for didactic and hands-on training. Objectives: The aim of this study was to offer HBB to nurses and nursing students in Guatemala, with the lead facilitator presenting concepts via telehealth and in-person facilitators providing hands-on demonstration. Methods: Learners completed pre- and post-tests that included the standard HBB knowledge check, as well as an assessment of the course teaching model. Learners also completed the standard Objective Structured Clinical Evaluations (OSCEs). Results: Eighteen learners were included in the analysis. All but one learner (94%) passed the course, and the average percent improvement from the pre- to post-test was 12%. All learners achieved passing scores on the OSCEs. Learners responded positively to questions regarding the technology, connection with the instructor, and ability to ask questions. Ninety-four percent of the learners agreed with the statement “this lecture was as good via telehealth as in person.” A cost analysis demonstrated approximately USD 3,979.00 in savings using telehealth compared to a standard in-person course. Conclusions: The telehealth model was successful in delivering course material to the learners and was well received. This model represents a cost-effective way to improve access to HBB. This study may not be generalizable to other populations, and the ability to use telehealth requires reliable internet connectivity, which may not be available in all settings. Further study and expansion of this pilot are needed to assess success in other settings.

eHBB: a randomised controlled trial of virtual reality or video for neonatal resuscitation refresher training in healthcare workers in resource-scarce settings

“…44 In settings where in-person refresher training is costly and potentially challenging, and may be even more difficult within the context of COVID-19 concerns, digital and telehealth interventions may adequately support the retention of neonatal resuscitation knowledge and skills. 45 Little is known about the feasibility and acceptability of VR as a novel educational modality for training HCWs in resource-scarce settings. Previous descriptions of mobile VR use with school-age children in LMICs suggest that mobile VR simulations can be used to demonstrate realworld phenomena, illustrate abstract concepts and motivate learners.…”

Implementation of the Helping Babies Breathe Training Program: A Systematic Review

“…86 In a 3-year study on HBB program implementation in 15 regions in Tanzania, an assessment of the program's impact on neonatal mortality proved to be challenging because of the poor availability of historical, preintervention data. 25 88 Recent uses of technology to cut costs and ease logistic burden of implementation include training via video conferencing 61 and mobile apps 41 as well as the use of a highfidelity mannequin that provides feedback based on resuscitation performance. 58 HBB implementation translates into meaningfully improved skills and knowledge as demonstrated through multiple studies in which authors cite improved average OSCE scores and pass rates on knowledge assessments.…”

Adapting Helping Babies Breathe into a Virtual Curriculum: Methods, Results, and Lessons Learned

“…One study did examine teaching the course via telehealth methods and demonstrated efficacy with HBB training, but did not provide a comparison to in-person learning. 6 This study offers the first direct comparison of virtual to in-person learning of HBB, to date, and demonstrates that a virtual HBB course is non-inferior to an in-person course.…”