Summary of serious games in neonatology
| Game | Learning objective | How to play | Availability | Feedback | Assessment of the game | |
| Learners’ attitude | Educational outcomes | |||||
| Board games | ||||||
| RETAIN board game | Tabletop simulator to train interdisciplinary HCPs’ neonatal resuscitation knowledge and communication/teamwork skills. | After prebrief, learners use 3D equipment pieces and informative action cards to perform neonatal resuscitation. A facilitator is required to provide players with ongoing heart rate and oxygen saturation. Debrief cards are used. | The game is under development (US$200). There are currently 50 evidence-based real-life resuscitation cases from the delivery room of a tertiary care centre. | Performance scored based on adherence to the NRP-based answer key for each scenario in the supplementary case booklet. The facilitator may provide specific feedback. | Not reported. | NRP providers who played three rounds of RETAIN experienced an increase in short-term knowledge retention of the overall NRP algorithm on an open-answer neonatal resuscitation scenario, with significant improvements in temperature management. |
| The Neonatology Game | Trivia-based board game to teach neonatal curriculum to undergraduate medical students. | Working in teams of four, players roll a dice and answer neonatology quiz questions to move along the board. Informative neonatal summary cards are provided. | The game is part of the neonatal unit of the University of Glasgow’s medical curriculum. Questions are based on a standard paediatrics textbook. | Performance scored based on the number of correctly answered questions accumulated by each team. | Medical students indicated the game was useful, fun and an interesting way to learn. Students found the summary cards particularly useful. | Medical students who played the game+standard curriculum had a higher mean post-test score on a final written neonatology examination, compared with students who received standard curriculum alone. |
| Neonatal Emergency Trivia Game | Trivia-based board game for HCPs to review neonatology in preparation for emergency clinical situations. | Divided into two teams, players roll a dice to determine the trivia category (ie, pathophysiology, resuscitation or medication) of a neonatal medicine question to answer within 2 min. A facilitator is required to organise and debrief questions during play. | The game contains 101 peer-reviewed validated short-answer questions and answers. | Performance scored based on the number of correctly answered questions in each trivia category accumulated by each team. Five points are awarded for each correct answer, and the team with the most points at the end wins. | Nurses indicated the game was easy to play, clinically applicable, helpful and would recommend it to their peers. | Not reported. |
| Neonopoly | Not reported. | Not reported. | Not reported. | Not reported. | Midwives indicated the game was enjoyable, easy to learn and intended to use it again. The number of question cards was evaluated as insufficient. | Not reported. |
| Computer games | ||||||
| NRP eSim | Digital neonatal resuscitation simulator to be completed before attending the in-class NRP provider course. | After prebrief and equipment check, players use equipment and interventions to perform neonatal resuscitation. Players assess breathing, heart rate and visually to guide their actions. | Accessible after payment for the NRP provider course (US$35). There are currently four repeatable scenarios. A free-trial scenario is available from AAP (no learner feedback provided). | Performance scored based on adherence to the NRP algorithm. Players receive a debrief, timestamped list of their actions, and final percentage score. | Not reported. | NRP providers who were prepared with the eSim+NRP textbook performed several algorithm steps more correctly than NRP providers with the textbook alone on an in-person simulation, but no difference between groups in time needed to perform key NRP steps. |
| RETAIN video game | Digital neonatal resuscitation simulator to train HCPs’ knowledge of the resuscitation algorithm. | After prebrief and equipment check, players choose equipment and interventions (guided by changes in heart rate, breathing, oxygen saturation and visual assessment) to perform simulated resuscitations in real time. | The game is under development. There are currently 50 evidence-based real-life resuscitation cases from the delivery room of a tertiary care centre. | Performance scored based on adherence to the NRP algorithm and successful stabilisation of the newborn. Players receive a timestamped list evaluation of their actions. | Players reported stress during RETAIN due to the gravity of the simulated consequences. Neonatologists evaluated the game as an engaging learning experience. | Not reported. |
| Scottish Neonatal Resuscitation Game | Digital neonatal resuscitation simulator to train knowledge and psychomotor skills of rural HCPs with infrequent birth attendance. | After selecting difficulty level and clinical setting, players answer questions and choose interventions to practise their resuscitation skills on a simulated newborn. | The game (US$4.99) is not available for download as it requires updating. There were six scenarios developed for the NHS Scottish Multiprofessional Maternity Development Neonatal Resuscitation course. | Performance is scored based on performance of interventions and correctly answered questions. Players receive a final score which is submitted to the NHS Education Scotland leaderboard. | Not reported. | Not reported. |
| Singapore Neonatal Resuscitation Game | Digital neonatal resuscitation simulator to retrain and assess experienced HCPs’ knowledge and skills. | After selecting difficulty level, players independently assemble equipment and perform resuscitations as team leader within a time limit. | There are three available categories of resuscitation scenarios, based on gestational age. | Performance is scored based on knowledge, skills, leadership and appropriateness of interventions. Players receive a timestamped list of their actions and a final score. | Not reported. | Not reported. |
| eBaby | Computer game to assess knowledge and train nursing students to manage oxygenation problems in preterm babies. | After receiving medical history, players choose clinical assessment tools and answer questions about neonatal respiratory problems. | Players are presented with several infants throughout the game, with mild to serious respiratory problems. | Performance is scored based on correct answers to the multiple-choice questions. | Nursing students rated the game as enjoyable, autonomous, accountable, easy to use and easy to learn information. | Not reported. |
| eHBB | Digital and VR neonatal resuscitation simulator based on HBB to train HCPs in low-resource settings. | Players manage neonatal resuscitation simulation scenarios by administering interventions. | The game was developed to supplement in-person HBB training to maintain HCPs’ knowledge and skills. There are three simulation scenarios available. | Performance is scored based on adherence to the HBB guidelines. Player feedback is provided. | HCPs from Nigeria reported eHBB was easy to use, interesting, educational and facilitated learning without stress. | There is an ongoing randomised controlled trial in Nigeria and Kenya to examine educational outcomes of eHBB training. |
| LIFE | Digital and VR neonatal resuscitation simulator based on ETAT+ to train HCPs in low-resource settings. | Players manage simulated neonatal resuscitations in a rural setting by finding equipment, administering interventions and answering questions. | The game was developed to supplement in-person ETAT+ training to practise HCPs’ knowledge and skills. | Performance is scored based on adherence to ETAT+ guidelines, timely delivery of interventions and correct answers to questions. | Not reported. | Not reported. |
| Compromised Neonate Program | Digital and VR neonatal resuscitation simulator to teach midwifery students’ neonatal skills. | Working independently or with the help setting, players perform neonatal resuscitations within realistic time limits. | The game was developed to supplement the University of Newcastle midwifery course curriculum. | Performance is scored based on adherence of actions to the correct resuscitation algorithm. | Not reported. | There is an ongoing randomised controlled trial in Australia of midwifery students’ educational outcomes with the game+standard curriculum compared with the standard curriculum alone. |
3D, three dimensional; AAP, American Academy of Pediatrics; eHBB, Electronic Helping Babies Breathe; ETAT, Emergency Triage, Assessment and Treatment Plus; HCP, healthcare professional; LIFE, Life-saving Instructions For Emergencies; NRP, Neonatal Resuscitation Program; RETAIN, REsuscitation TrAINing for healthcare professionals; VR, virtual reality.