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Web-based versus simulation-based refresher training in newborn life support: A randomized multicenter noninferiority
Kathleen Parthey1, Anne Goldhahn1, Anselm Linke2
1Department of Pediatrics II, University Hospital, Martin Luther University Halle-Wittenberg, Halle, Germany.
Resuscitation Plus
|June 29, 2026
Summary
Web-based refresher training for newborn life support is as effective as simulation-based training, showing non-inferiority in skill retention. This online approach also achieved higher participation rates among healthcare professionals.
Area of Science:
- Medical Education
- Emergency Medicine
- Neonatal Care
Background:
- Regular training in newborn life support is critical for healthcare professionals.
- Web-based refresher training presents a viable alternative to traditional simulation-based methods.
- Assessing skill decay after refresher training is essential for maintaining competency.
Purpose of the Study:
- To evaluate if web-based refresher training is non-inferior to simulation-based refresher training in preventing skill decay in newborn life support.
- To compare participation rates between web-based and simulation-based refresher training groups.
- To identify recurring errors in newborn life support skills.
Main Methods:
- A multicenter non-inferiority randomized controlled trial was conducted across six German hospitals.
- Healthcare professionals received either web-based or simulation-based refresher training after initial simulation training.
- Participants were assessed using questionnaires and Megacode tests at three time points: pre-training, immediately post-training, and three months post-intervention.
Main Results:
- The web-based refresher group demonstrated non-inferiority to the simulation-based group in preventing skill decay, with mean sum scores of 45.2 ± 6.5 and 47.0 ± 5.6, respectively, three months post-refresher.
- The lower limit of the one-sided 95% confidence interval did not exceed the predefined non-inferiority margin of 5 points in both per-protocol and modified intention-to-treat analyses.
- Participation rates were 14% higher in the web-based refresher group.
- Recurring errors included incorrect adrenaline application and ventilation fraction.
Conclusions:
- Web-based refresher training appears to be non-inferior to simulation-based training for maintaining practical skills in newborn life support.
- The higher participation rate suggests web-based training may improve accessibility and engagement.
- While the study was underpowered for definitive conclusions, results indicate the potential of web-based methods in neonatal resuscitation education.
