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Arch Dis Child Fetal Neonatal Ed. 2019 Jun 29. pii: fetalneonatal-2019-317011. doi: 10.1136/archdischild-2019-317011. [Epub ahead of print]

Serious games, a game changer in teaching neonatal resuscitation? A review.

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Centre for the Studies of Asphyxia and Resuscitation, Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, Alberta, Canada.
Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonoton, Alberta, Canada.
Faculty of Science, University of Alberta, Edmonoton, Alberta, Canada.
Centre for Research in Applied Measurement and Evaluation, University of Alberta, Edmonton, Alberta, Canada.
Department of Computing Science, University of Alberta, Edmonton, Alberta, Canada.
Academic Technology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.



Neonatal healthcare professionals require frequent simulation-based education (SBE) to improve their cognitive, psychomotor and communication skills during neonatal resuscitation. However, current SBE approaches are resource-intensive and not routinely offered in all healthcare facilities. Serious games (board and computer based) may be effective and more accessible alternatives.


To review the current literature about serious games, and how these games might improve knowledge retention and skills in neonatal healthcare professionals.


Literature searches of PubMed, Google Scholar, Cochrane Central Register of Controlled Trials, CINAHL, Web of Science and EMBASE databases were performed to identify studies examining serious games in neonatology. All games, such as board games, tabletop games, video games, screen-based simulators, tabletop simulators and virtual reality games were included.


Twelve serious games were included in this review (four board games, five video games and three virtual reality games). Overall, knowledge improvement was reported for the RETAIN (REsuscitationTrAINing for healthcare professionals) board game (10% increase in knowledge retention) and The Neonatology Game (4.15 points higher test score compared with control). Serious games are increasingly incorporated into Nursing and Medical School Curriculums to reinforce theoretical and practical learning.


Serious games have the potential to improve healthcare professionals' knowledge, skills and adherence to the resuscitation algorithm and could enhance access to SBE in resource-intensive and resource-limited areas. Future research should examine important clinical outcomes in newborn infants.


newborn; resuscitation; serious games; teaching

Conflict of interest statement

Competing interests: MRGB, PvH and GMS have registered the RETAIN board game (Tech ID 2017083) and the RETAIN video game under Canadian copyright (Tech ID 2017086). MRGB and GMS are owners of RETAIN Labs Medical, Edmonton, Alberta, Canada (, which is distributing the game.

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