Effectiveness of simulation-based continuing education in neonatal resuscitation among Moroccan midwives: A quasi-experimental study

Neonatal mortality remains a critical public health issue, particularly in resource-limited settings. Simulation-based programs such as Helping Babies Breathe (HBB) have proven effective in strengthening midwives' knowledge and skills in neonatal resuscitation, yet no study has evaluated their impact among practicing Moroccan midwives. The objective of this study was to assess the effectiveness of HBB training on satisfaction, self-efficacy, theoretical knowledge, one-year knowledge retention, and technical skills among practicing Moroccan midwives. A quasi-experimental pre-post study was conducted with 96 midwives. The intervention included a didactic session, hands-on practice, and formative simulation. Satisfaction, self-efficacy, and knowledge were measured through questionnaires; technical skills were evaluated using OSCE checklists for the Golden Minute and positive pressure ventilation. Satisfaction was 100%, and full self-efficacy increased markedly post-training. Knowledge improved significantly and remained stable at follow-up. Technical skills showed high scores with minimal failure rates. Knowledge moderately correlated with ventilation performance. In conclusion, HBB simulation-based training significantly enhances and sustains neonatal resuscitation competencies among Moroccan midwives, supporting its systematic integration into continuous professional development.