A comparative study of the use of extended reality simulation in neonatal resuscitation training

360° video and virtual reality (VR) simulation may offer innovative opportunities as portable simulation-based technologies to enhance Neonatal Resuscitation Program (NRP) training, updates, and refreshers. The purpose of this study was to compare the use of 360° video with VR simulation in NRP training and the effect on NRP learning outcomes.

Thirty (N = 30) NRP providers were randomly assigned to either VR simulation or 360° video study groups (n = 15 each) with pre and posttests of confidence, posttests of user satisfaction, usefulness, presence, and simulator sickness, and a performance demonstration of positive pressure ventilation (PPV) on a manikin-simulator. Participants were then exposed to the other condition and again post-tested.

Both systems were positively viewed. However, participants reported significantly higher perceptions of usefulness in enhancing learning and increased sense of presence with the VR simulation. VR simulation participants gained more confidence in certain NRP skills, such as proper mask placement (adjusted p-value 0.038) and newborn response evaluation (adjusted p-value 0.017). A blinded assessment of PPV skills showed participants exposed to VR performed significantly better in providing effective PPV (adjusted p-value 0.005).

NRP providers found both systems useful; however, VR simulation was more helpful in improving learning performance and enhancing learning. Participants reported an increased feeling of presence and confidence in certain areas with VR and performed better on a crucial NRP skill, providing effective PPV. VR technologies may offer an alternative modality for increasing access to standardized and portable refresher learning opportunities on NRP.