Impact of a 3-months recall using high-fidelity simulation or serious game simulation on learning retention during neonatal resuscitation training in delivery room. (Preprint)

Abstract

Retention capacities depends on the learning context. The optimal interval between two learning sessions to maintain the learner’s knowledge is often a subject of discussion, as well as the methodology used. Digital simulation could represent an easy alternative for re-training in neonatal resuscitation.

The aim of the study was to evaluate the benefits of a 3-month recall in high-fidelity simulation or digital simulation after an initial high-fidelity neonatal resuscitation training in simulation among anesthesia and intensive care residents.

All anesthesia and intensive care residents who participated were volunteers and they were trained in the same session (theoretical course and a high-fidelity simulation). Then, attendees were randomized in three groups: a first group with no 3-month recall, a second one with a high-fidelity simulation recall, and a last group with a digital simulation recall. In order to reassess the skills of each participant, a high-fidelity simulation has been performed at 6 months. The evaluation included some knowledge quiz on neonatal resuscitation, self-assessment of confidence, expert assessment of technical skills using the NRPE score, and non-technical skills assessed by the ANTS score. We compared the results between groups and intragroup progressions.

Twenty-eight participants were included in the study. No differences were observed between groups at the 6-month evaluation. However, we observed a significant improvement in theoretical knowledge and self-confidence among students over time. Concerning non-technical skills evaluated by the ANTS score, there was a significant improvement between the initial training and the session at 6 months in both groups that had a recall session. Regarding technical skills assessed by the NRPE score, there was a non-significant trend toward improvement in the two groups with recall, while a regression was observed in the control group. The increase of students' self-confidence was significant for each group, but it remained higher in the two groups that had a 3-month recall.

Initial training for anesthesia and intensive care residents in neonatal resuscitation leads to improved knowledge and self-confidence that persists at 6 months. A 3-month recall, whether through high-fidelity simulation or digital simulation, is showing better results on technical and non-technical skills (such as situation management and team communication). Digital simulation, while saving time and resources, seems to be an effective educational method for recall after initial training. The study’ outcomes are justifying the need of further studies, with larger attendance, to confirm the promising results of the serious games role in the educational programs for students.