Effect of low-cost interventions on the retention of knowledge and skills following Helping Babies Breathe training

Abstract

Objective: To evaluate the impact of a post-Helping Babies Breathe bundle of interventions on the retention of provider-level knowledge and skills.

Method: The present prospective pre-post study following a 1-day Helping Babies Breathe training of professional midwives, physicians, and nurses was conducted in Cajamarca Province, Peru between January 1 and July 31, 2017. The interventions to improve retention included structured worksite practice before every shift, weekly in-service simulated scenarios, and monthly supervised peer-to-peer abbreviated refresher trainings. Knowledge and skills were assessed before, immediately after, and 6 months after training using two validated multiple-choice knowledge test and objective structured clinical examinations (OSCEs; OSCE A and OSCE B). Data were analyzed for changes in knowledge and skills over time and to identify predictors of performance.

Results: There were 60 learners included. No significant differences were observed between assessments immediately after training and at 6-month follow-up for knowledge scores or time-to-effective-ventilation. Pass rates for OSCE B increased from 83% immediately after training to 95% at follow-up (P=0.007). The only factor associated with a reduced time to effective ventilation at 6-month follow-up was working in a hospital (P<0.001), accounting for years of training and experience.

Conclusion: Helping Babies Breathe knowledge and skills can be retained and even improved with simple, inexpensive interventions, including supervised on-the-job and peer-to-peer training.

Keywords: Helping Babies Breathe; Low-income countries; Neonatal resuscitation; Training outcomes.