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

Overview

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.

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Crossover Assignment
    • Primary Purpose: Health Services Research
    • Masking: Single (Outcomes Assessor)
  • Study Primary Completion Date: February 2026

Detailed Description

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.

Interventions

  • Other: Virtual Essential Newborn Care (vENC) training
    • Essential Newborn Care Mobile Virtual Reality Simulation

Arms, Groups and Cohorts

  • Experimental: Intervention
    • Virtual Essential Newborn Care (vENC) Training
  • No Intervention: Control
    • Standard of Care

Clinical Trial Outcome Measures

Primary Measures

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

Secondary Measures

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

Participating in This Clinical Trial

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

Gender Eligibility: All

Minimum Age: N/A

Maximum Age: N/A

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • University of Washington
  • Collaborator
    • Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
  • Provider of Information About this Clinical Study
    • Principal Investigator: Rachel Umoren, Assistant Professor, School of Medicine – University of Washington
  • Overall Official(s)
    • Rachel Umoren, Principal Investigator, University of Washington
  • Overall Contact(s)
    • John Feltner, 425 753 1134, jfeltner@uw.edu

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