Mobile Virtual Simulation Training in Essential Newborn Care for Healthcare Workers in Low and Middle Income Countries

Study Overview
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Brief Summary
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Intrapartum asphyxia and prematurity are the leading causes of neonatal mortality in low and middle income countries. Neonatal resuscitation training reduces asphyxia-related newborn mortality and morbidity, but in the absence of continuing low-dose, high frequency practice, these initial gains rapidly decay. The investigators propose to develop and evaluate innovative mobile virtual simulations for refresher training on neonatal resuscitation and essential newborn care to support the retention of knowledge and skills among health care workers in low and middle income countries.

Detailed Description
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The main goal of this study is to improve newborn mortality and morbidity by using affordable and accessible mobile virtual simulations to provide quality skills training and maintenance for healthcare workers in Low/Middle income countries (LMIC). The investigators hypothesize that mobile devices will provide a readily accessible, standardized alternative to in-person training to maintain skills. This study has the following Specific Aims: Specific Aim 1: Co-develop and pilot test the usability and efficacy of mobile virtual simulations on early newborn care skills among healthcare workers who attend deliveries in community and health facility-based settings. Specific Aim 2: Evaluate the impact of the mobile virtual essential newborn care (vENC) training on neonatal resuscitation and care educational indicators and performance outcomes among healthcare workers who provide newborn care in community and health facility-based settings. Specific Aim 3: Evaluate the impact of virtual simulation refresher training on the rates of neonatal mortality in primary, secondary and tertiary healthcare facilities in Nigeria.

Official Title
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Mobile Virtual Simulation Training in Essential Newborn Care for Healthcare Workers in Low and Middle Income Countries

Conditions
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Resuscitation

Intervention / Treatment
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* Other: Virtual Essential Newborn Care (vENC) training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Must have a direct clinical role related to newborn care Is able and willing to attend and complete study-related engagements Exclusion Criteria: Healthcare workers who have received essential newborn care course (ENCC) training within the past 12 months at time of recruitment
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention<br>Virtual Essential Newborn Care (vENC) Training | Other: Virtual Essential Newborn Care (vENC) training<br>* Essential Newborn Care Mobile Virtual Reality Simulation<br>|
| No Intervention: Control<br>Standard of Care | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of participants with correct performance on essential newborn care objective structured clinical exam (OSCE) items at 6 months |  | at 6 months after in-person training | 
| Early neonatal mortality | Defined as neonatal mortality within 7 days of birth | within 7 days of birth | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of participants with correct performance on essential newborn care objective structured clinical exam (OSCE) items by 12 months |  | at 12 months after in-person training | 
| Number of non-breathing newborns receiving bag and mask ventilation |  | at delivery | 
| Number of newborns receiving recommended essential newborn care practices | WHO essential newborn care practices include skin to skin immediately after birth, cord care, early breastfeeding and vitamin K administration | within 7 days of birth | 
| Intrapartum-related mortality | Defined as intrapartum stillbirth (no breathing 10 minutes after delivery) | on day 1 | 
| Early neonatal mortality among babies requiring resuscitation | Defined as neonatal mortality within 7 days of birth among babies requiring resuscitation | within 7 days of birth | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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neonatal, resuscitation, education, virtual, simulation, mobile, phone