Kfoury Peter, Maalouf Faouzi, Nasser Fatima, Gulgulian Talin, Charafeddine Lama
Faculty of Medicine, American University of Beirut Medical Center, Beirut, LBN.
Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, LBN.
Cureus. 2024 Jul 16;16(7):e64677. doi: 10.7759/cureus.64677. eCollection 2024 Jul.
Birth asphyxia is a leading cause of neonatal deaths, but simple interventions may prevent it. The Helping Babies Breathe (HBB) course has significantly reduced neonatal mortality rates in lower and middle-income countries (LMICs) by training healthcare providers (i.e. midwives and nurses) on the essential skills of bag-and-mask ventilation and postnatal care. Although several studies have supported the efficacy of virtual learning in other medical education programs, there is still a lack of knowledge regarding a virtual approach to HBB. This study aims to compare the effectiveness of online versus in-person learning of the HBB course among medical and nursing students.
The study is a two-arm parallel randomized non-inferiority controlled trial, that includes medical and nursing students. Participants were randomly assigned to either online or in-person debriefing during the hands-on simulations of HBB. They attended a pre-recorded lecture before being assigned to one of three instructors for the simulation lab. Participants completed a seven-point anonymous Likert-based questionnaire and a standardized Debriefing Assessment for Simulation in Healthcare Student Version (DASH-SV) Short Form. The primary outcome was the Objective Structured Clinical Exam (OSCE) grade. The trial is listed on ClinicalTrials.gov with the registration number NCT05257499.
47 participants completed the study, with similar baseline characteristics in each arm (gender, age, and class). The participants in both arms reported high levels of satisfaction and confidence, with no significant difference between the two arms. The DASH score over 7 was also similar in the online arm (6.27±0.26) compared to the in-person arm (6.55±0.13) (p=0.07). The mean OSCE score in the online arm (45.8±5.2) was comparable to the mean OSCE score in the in-person arm (41.3±5.0) (p=0.22). Both online and in-person participants failed the OSCE.
The survey responses conveyed that online simulation training is comparable to in-person simulation for the HBB course. Both online and in-person participants failed the OSCE most likely because they needed more training on HBB. This could be due to the fact that the material is too new to the students who needed more practice to pass the OSCE. Further research is needed to confirm these results and explore the long-term impact of online neonatal resuscitation training.
出生窒息是新生儿死亡的主要原因之一，但简单的干预措施可能预防其发生。“帮助婴儿呼吸”（HBB）课程通过培训医疗保健提供者（即助产士和护士）掌握袋面罩通气和产后护理的基本技能，显著降低了低收入和中等收入国家（LMICs）的新生儿死亡率。尽管多项研究支持虚拟学习在其他医学教育项目中的有效性，但对于HBB的虚拟教学方法仍缺乏了解。本研究旨在比较医学和护理专业学生在线学习与面对面学习HBB课程的效果。
本研究为双臂平行随机非劣效性对照试验，纳入医学和护理专业学生。在HBB的实践模拟过程中，参与者被随机分配到在线或面对面的汇报环节。在被分配到三名指导教师之一参加模拟实验室之前，他们先观看了一段预先录制的讲座。参与者完成了一份基于李克特量表的七点匿名问卷以及一份标准化的《医疗保健学生版模拟汇报评估》（DASH-SV）简表。主要结局指标为客观结构化临床考试（OSCE）成绩。该试验已在ClinicalTrials.gov上注册，注册号为NCT05257499。
47名参与者完成了研究，两组的基线特征（性别、年龄和年级）相似。两组参与者均报告了较高的满意度和信心，两组之间无显著差异。在线组的DASH得分超过7分的情况（6.27±0.26）与面对面组（6.55±0.13）相似（p = 0.07）。在线组的平均OSCE成绩（45.8±5.2）与面对面组的平均OSCE成绩（41.3±5.0）相当（p = 0.22）。在线和面对面的参与者OSCE均未通过。
调查结果表明，对于HBB课程，在线模拟培训与面对面模拟相当。在线和面对面的参与者OSCE均未通过，最有可能的原因是他们需要更多关于HBB的培训。这可能是因为该材料对学生来说太新，他们需要更多练习才能通过OSCE。需要进一步的研究来证实这些结果，并探索在线新生儿复苏培训的长期影响。
