Tele-education vs classroom training of neonatal resuscitation: a randomized trial

Objective: To compare gain in knowledge and skills of neonatal resuscitation using tele-education instruction vs conventional classroom teaching. Study Design: This randomized controlled trial was conducted in the tele-education facility of a tertiary care center. In-service staff nurses were randomized to receive training by tele-education instruction (TI, n = 26) or classroom teaching (CT, n = 22) method from two neonatology instructors using a standardized teaching module on neonatal resuscitation. Gain in knowledge and skill scores of neonatal resuscitation were measured using objective assessment methods. Result: Age, educational qualification and professional experience of the participants in two groups were comparable. Pre-training mean knowledge scores were higher in TI group (8.3 +/- 1.7 vs 6.6 +/- 1.4, P = 0.004). However, skill scores were comparable in the two groups (11.7 +/- 3 vs 10.3 +/- 2.9, P = 0.13). Training resulted in a significant and comparable gain in knowledge scores (4.2 +/- 2.2 vs 5.3 +/- 1.7; P = 0.06) and skills scores (4.5 +/- 3.3 vs 5.0 +/- 3.1, P = 0.62) in both the groups. The post-training knowledge scores (TI: 12.5 +/- 1.7 vs CT: 12.0 +/- 1.7, P = 0.37) and the post-training skill scores (TI: 16.0 +/- 0.5 vs CT: 15.6 +/- 2.5, P = 0.55) were comparable in the two groups. However, the post-training scores, adjusted for baseline knowledge scores, were statistically higher in the in-person group compared with the telemedicine group (knowledge: 12.46 +/- 0.03 vs 12.16 +/- 0.01, P = 0.00; skills: 15.6 +/- 2.5 vs 16.0 +/- 2.8, P = 0.00). The quantum of lower scores in the telemedicine group was only 2% for knowledge and 6% for skills. This difference was felt to be of only marginal importance. Satisfaction scores among trainees and instructors were comparable in the two groups. Conclusion: Tele-education offers a feasible and effective alternative to conventional training in neonatal resuscitation among health-care providers. Journal of Perinatology (2010) 30, 773-779; doi: 10.1038/jp.2010.42; published online 1 April 2010