Neonatal assessment and VR: designing 3D simulation training for prehospital clinicians

Abstract Prehospital emergency care requires clinicians to manage a vast array of medical and trauma incidents, including rare events such as obstetrics (i.e., childbirth) emergencies. Emergency births can have life-threatening complications such as neonatal respiratory distress potentially leading to cardiopulmonary resuscitation. Management of low-frequency high-risk (LFHR) events such as birthing and immediate neonatal care occurring outside the planned place of birth require expert clinical management. Underutilised skill and knowledge of LFHR events decay within 12-months of being taught. LFHR events are often overlooked for refresher training due to the low occurrence of such cases, putting LFHR patients at even greater risk of complications. This paper outlines the development of a 3D virtual reality (VR) simulation training program: Novel Educational Overview of the Neonatal Apgar and Treatment Experience in Virtual Reality ( NEONATE in VR ) for prehospital clinicians. Using an adapted version of the seven-step systematic and iterative user-centred development framework, our methodology included: (1) forming an expert multidisciplinary design team; (2) defining the problem and establishing user and educator preferences; (3) incorporating the evidence base; (4) simulation assessment design; (5) incorporating experiential learning theory; (6) developing a logic model and (7) user testing. This adapted model was highly efficacious in the development of NEONATE in VR and would be suitable for further obstetrics simulation training programs. This model should also be considered when undertaking research and development of other educational VR programs in healthcare.