805 - Technological Barriers and Facilitators of Virtually Adapted Neonatal Resuscitation Curriculum In Ethiopia: A Qualitative Study

Publication Number: 805.6797

Vaishnavi Bhamidi, Stanford University School of Medicine, Stanford, CA, United States; Bethel A. Bayrau, University of California, Los Angeles David Geffen School of Medicine, Los Angeles, CA, United States; Beza Eshetu Alemu, Jimma University, Jimma, Oromiya, Ethiopia; Lulu M. Muhe, Addis Ababa University, Addis Ababa, Adis Abeba, Ethiopia; Kay Daniels, Stanford Health Care, Palo alto, CA, United States; Henry C. Lee, University of California, San Diego School of Medicine, La Jolla, CA, United States; Max Clary, Stanford University School of Medicine, Los Gatos, CA, United States; Melkamu Berhane. Arefayine, Jimma University, Jimma, Oromiya, Ethiopia; Rishi Mediratta, Stanford University School of Medicine, Palo Alto, CA, United States

Background: Neonatal resuscitation training has been delivered virtually in some low- and middle-income countries. However, the technological barriers and facilitators of virtual delivery are not well known.

Objective: Explore the technological barriers and facilitators of virtual neonatal resuscitation training among Ethiopian medical students.

Design/Methods: Medical students in Jimma, Ethiopia were invited to focus group discussions (FGDs) two months after completing a two-arm parallel randomized control trial, which involved one day of virtual or in-person neonatal resuscitation training. Virtual participants received Zoom pre-training. FGDs were recorded, transcribed, and translated from Amharic to English. A qualitative thematic analysis with an inductive narrative approach was used until reaching thematic sufficiency. Researchers independently generated and reconciled codes through consensus. Themes about technological barriers and facilitators were generated inductively. Participants consented before participation.

Results: Seventeen medical students (7 in year IV, 9 in year V, 1 in year VI) participated in three FGDs (5-7 per group; 10 virtual, 7 in-person). Seven themes were developed: four facilitators (Table 1) and three barriers (Table 2). Participants who received in-person training believed that virtual training was insufficient to teach neonatal resuscitation skills and internet connectivity would be a barrier to participation. However, most participants in the virtual arm did not face device or internet issues. Virtual arm participants felt that the training provided convenience and comfort. They avoided traditional obstacles to in-person learning, such as crowding in a classroom and difficulty hearing the trainer. Virtual training allowed participants to practice skills without performance pressures. Some barriers the virtual arm faced included requesting re-demonstrations, setting up their camera, and muting audio.

Conclusion(s): Virtual neonatal resuscitation training offers key advantages, such as convenience and eliminating in-person audibility challenges. This approach can expand healthcare training globally. However, attention is needed to address connectivity issues, real-time feedback, and the learning curve associated with virtual learning. Facilitators implementing virtual neonatal resuscitation training should consider muting participants during instructional components, offer suggestions to participants on how to position the camera before and during the beginning of training, and offer additional opportunities to practice bag-mask ventilation in a breakout room if desired by participants.

Table 1. Technological facilitators of virtual neonatal skill learning.


Table 2. Technological barriers of virtual neonatal skill learning.