{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T21:28:17Z","timestamp":1793914097386,"version":"4.8.0"},"reference-count":58,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2021,8,24]],"date-time":"2021-08-24T00:00:00Z","timestamp":1629763200000},"content-version":"unspecified","delay-in-days":23,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1169873"],"award-info":[{"award-number":["OPP1169873"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2021,8,5]]},"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess the impact of mobile virtual reality (VR) simulations using electronic Helping Babies Breathe (eHBB) or video for the maintenance of neonatal resuscitation skills in healthcare workers in resource-scarce settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Randomised controlled trial with 6-month follow-up (2018\u20132020).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Secondary and tertiary healthcare facilities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>274 nurses and midwives assigned to labour and delivery, operating room and newborn care units were recruited from 20 healthcare facilities in Nigeria and Kenya and randomised to one of three groups: VR (eHBB+digital guide), video (video+digital guide) or control (digital guide only) groups before an in-person HBB course.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention(s)<\/jats:title>\n                    <jats:p>eHBB VR simulation or neonatal resuscitation video.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome(s)<\/jats:title>\n                    <jats:p>Healthcare worker neonatal resuscitation skills using standardised checklists in a simulated setting at 1\u2009month, 3 months and 6 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Neonatal resuscitation skills pass rates were similar among the groups at 6-month follow-up for bag-and-mask ventilation (BMV) skills check (VR 28%, video 25%, control 22%, p=0.71), objective structured clinical examination (OSCE) A (VR 76%, video 76%, control 72%, p=0.78) and OSCE B (VR 62%, video 60%, control 49%, p=0.18). Relative to the immediate postcourse assessments, there was greater retention of BMV skills at 6 months in the VR group (\u221215% VR, p=0.10; \u221221% video, p&lt;0.01, \u201327% control, p=0.001). OSCE B pass rates in the VR group were numerically higher at 3 months (+4%, p=0.64) and 6 months (+3%, p=0.74) and lower in the video (\u221221% at 3 months, p&lt;0.001; \u221214% at 6 months, p=0.066) and control groups (\u22127% at 3 months, p=0.43; \u221214% at 6 months, p=0.10). On follow-up survey, 95% (n=65) of respondents in the VR group and 98% (n=82) in the video group would use their assigned intervention again.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>eHBB VR training was highly acceptable to healthcare workers in low-income to middle-income countries and may provide additional support for neonatal resuscitation skills retention compared with other digital interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2020-048506","type":"journal-article","created":{"date-parts":[[2021,8,25]],"date-time":"2021-08-25T13:11:56Z","timestamp":1629897116000},"page":"e048506","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":62,"title":["eHBB: a randomised controlled trial of virtual reality or video for neonatal resuscitation refresher training in healthcare workers in resource-scarce settings"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2356-9278","authenticated-orcid":false,"given":"Rachel","family":"Umoren","sequence":"first","affiliation":[{"name":"Department of Pediatrics, University of Washington, Seattle, Washington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sherri","family":"Bucher","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel S","family":"Hippe","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Washington, Seattle, Washington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatrice Nkolika","family":"Ezenwa","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, University of Lagos College of Medicine, Lagos, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iretiola Bamikeolu","family":"Fajolu","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, University of Lagos College of Medicine, Lagos, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felicitas M","family":"Okwako","sequence":"additional","affiliation":[{"name":"Alupe University College, Busia, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Feltner","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Washington, Seattle, Washington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Nafula","sequence":"additional","affiliation":[{"name":"Alupe University College, Busia, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annet","family":"Musale","sequence":"additional","affiliation":[{"name":"Alupe University College, Busia, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olubukola A","family":"Olawuyi","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, University of Lagos College of Medicine, Lagos, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christianah O","family":"Adeboboye","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, University of Lagos College of Medicine, Lagos, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ime","family":"Asangansi","sequence":"additional","affiliation":[{"name":"eHealth4everyone, Abuja, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Paton","sequence":"additional","affiliation":[{"name":"Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saptarshi","family":"Purkayastha","sequence":"additional","affiliation":[{"name":"Department of BioHealth Informatics, Indiana University-Purdue University at Indianapolis, Indianapolis, Indiana, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chinyere Veronica","family":"Ezeaka","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, University of Lagos College of Medicine, Lagos, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabian","family":"Esamai","sequence":"additional","affiliation":[{"name":"Alupe University College, Busia, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,8,25]]},"reference":[{"key":"2025121409532364000_11.8.e048506.1","unstructured":"UNICEF . 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