Comparison of Virtual Reality-based and traditional mannequin-based simulation training for neonatal resuscitation in resource-limited settings: A non-inferiority randomized controlled trial
Improvement of neonatal resuscitation skills and knowledge in healthcare workers
Participants will be randomized in a 1:1 ratio to one of two study arms after completion of baseline assessments. Intervention arm (Virtual Reality training): Participants will receive immersive virtual reality (VR)-based neonatal resuscitation training using a Meta Quest 3 headset. Following an initial tutorial and orientation session, participants will complete self-directed, low-volume high-frequency VR simulation training sessions over a 6 to 8 week period. Training sessions will be short (<30 minutes), flexible, and completed individually. Training frequency and duration will be recorded throughout the intervention period. Control arm (Traditional simulation training): Participants will receive standard instructor-led neonatal resuscitation training through a one-day mannequin-based Essential Newborn Care (ENC 1) training programme delivered by certified instructors during the 6 to 8 week study period. All participants will undergo baseline assessments before randomization and endline assessments 6 to 8 weeks later. Assessments include standardized mannequin-based neonatal resuscitation simulations and a neonatal resuscitation knowledge test. Participants in the VR arm will additionally complete questionnaires evaluating workload, motivation, usability, and potential VR-related side effects, and may participate in qualitative interviews regarding their training experience. The total follow-up period for both study arms is 6 to 8 weeks. Randomization will be conducted using a computer-generated allocation sequence created by an independent data management provider (Frontal Lobe ApS) using the Sealed Envelope randomization service. Participants will be randomized in a 1:1 ratio using restricted randomization with variable block sizes and stratification by profession. Allocation concealment will be ensured through the REDCap randomization module, with treatment assignments revealed only after participant enrolment and completion of baseline assessments. Outco
Midwives, nurses, doctors and medical assistants directly involved in deliveries and newborn care
1. Unwilling to give informed consent 2. Change of workplace before endline or unable to participate in the study until endline 3. Previously attended any formal training with VR 4. Not fully proficient in Bengali or English