Helping Babies Breathe (HBB) in a Pandemic: Breathing New Life into an Established Curriculum by Utilizing a Video Communication Platform

Abstract

Rationale: The Helping Babies Breathe (HBB) curriculum is an established, effective method to combat neonatal mortality worldwide. However, during the COVID-19 pandemic international travel largely ceased. In 2020 there were six HBB courses taught, compared to over 100 global trips and master training courses taught in 2019. In 2020, learners at all levels began utilizing video-based platforms for meetings, lectures, and even social activities. In the present study, we analyzed whether HBB could be modified into a video-based course. Methods: Prior to the start of the course, two HBB master trainers modified the HBB curriculum into a condensed hybrid course. Participants were randomly divided into two cohorts based on learner type;an in-person learner group and a “Zoom” learner group in a separate conference room. Participants were given a pre and post-course confidence survey consisting of 10 statements answered using a 10-point Likert scale. Responses were assigned a numerical value from zero to nine, with increasing numerical value indicating increased confidence. Data were analyzed using IBM SPSS to run Wilcoxon signed rank tests to compare pre and post-test responses. After the course, each participant completed a previously validated written knowledge check and was observed by a trained instructor on two objective structured clinical examinations (OSCE). All participants passed both the knowledge check and both OSCE's. Results: Figure 1 shows the average Likert scale score for each survey question pre-course and postcourse by learner type. Figure 1: Pre and Post HBB Course Confidence Rating by Learner Type When comparing pre-and post-course survey data among the in-person learners, all questions had a statistically significant increase in confidence (p=0.005). Among Zoom learners, there was also a statistically significant increase from pre-course to post-course confidence (p=0.005). There was no statistically significant difference between the Zoom or In Person learners' confidence in skills or knowledge (p= 0.747). Conclusions: Our data shows teaching HBB through a video-based platform is an effective alternative to in-person learning. The development of this course serves as a model for global health education, with large impacts both during and after the current pandemic. This model would reduce the monetary cost of HBB training trips, and has the potential to reach delivery providers in rural or unsafe areas that were previously inaccessible. In addition, follow up studies show that long term skill acquisition declines over time. Video-communication platforms would facilitate the implementation of frequent reassessments in areas with existing HBB infrastructure.