Evidence map›Paper›PMID 42289668›Full record

ArticleBMC medical education2026

The development of a consensus-based curriculum for a Bespoke Online Neonatal Education for Transfers (BONNETs) course.

Shakti Pillay, Jessica Head, Alan Horn, Wardi de Wet, Ruth Davidge, Maxine Dickson-Hall, Grant Felix, Gugu Kali, Waseela Khan, Bradley Klein and 5 more

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Article in BMC medical education, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

15 authors.

Shakti PillayDepartment of Paediatrics and Child Health, Division of Neonatology, Faculty of Health Sciences,Groote Schuur Hospital, University of Cape Town, Main Rd Observatory, Cape Town, 7925, South Africa. shakti.pillay@uct.ac.za.
Jessica HeadDepartment of Family, Community, and Emergency Care, Division of Emergency Medicine, University of Cape Town, Cape Town, South Africa.
Alan HornDepartment of Paediatrics and Child Health, Division of Neonatology, Faculty of Health Sciences,Groote Schuur Hospital, University of Cape Town, Main Rd Observatory, Cape Town, 7925, South Africa.
Wardi de WetCritical Care Retrieval And Aeromedical Services, ER24, Cape Town, South Africa.
Ruth DavidgeNeonatal Nurses Association of South Africa, Pietermaritzburg, South Africa.
Maxine Dickson-HallCritical Care Retrieval And Aeromedical Services, ER24, Cape Town, South Africa.
Grant FelixWestern Cape Department of Health and Wellness, Emergency Medical Services, Cape Town, South Africa.
Gugu KaliDepartment of Paediatrics and Child Health, Division of Neonatology, Stellenbosch University, Cape Town, South Africa.
Waseela KhanDepartment of Family, Community, and Emergency Care, Division of Emergency Medicine, University of Cape Town, Cape Town, South Africa.
Bradley KleinWestern Cape Department of Health and Wellness, Emergency Medical Services, Cape Town, South Africa.
Firdose NakwaDepartment of Paediatrics and Child Health, School of Clinical Medicine, Chris Hani Baragwanath Academic Hospital, University of the Witwatersrand, Johannesburg, South Africa.
Maryna VenterDepartment of Family, Community, and Emergency Care, Division of Emergency Medicine, University of Cape Town, Cape Town, South Africa.
Neville VlokDepartment of Family, Community, and Emergency Care, Division of Emergency Medicine, University of Cape Town, Cape Town, South Africa.
Martie WegeDepartment of Paediatrics and Child Health, Division of Paediatric Intensive Care, Greys Hospital, University of KwaZulu Natal, Pietermaritzburg, South Africa.
Willem StassenDepartment of Family, Community, and Emergency Care, Division of Emergency Medicine, University of Cape Town, Cape Town, South Africa.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHigh neonatal mortality in Sub-Saharan Africa (SSA) is driven by multiple systemic barriers, including insufficient neonatal transport infrastructure and limited provider training. Although specially trained neonatal retrieval teams are recommended for interfacility neonatal transfers, resource constraints lead to non-specialist emergency medical services (EMS) cadres performing these roles, potentially compromising the safe transport of critically ill neonates.

objectiveTo develop a bespoke, online neonatal interfacility transfer curriculum, informed by expert consensus and South African research to address critical gaps in provider knowledge and confidence, thereby improving neonatal transfer outcomes.

methodsBuilding on Kern's Six-Step Framework for curriculum development, an initial curriculum was derived through a comprehensive literature review, a retrospective chart analysis of neonatal cases in South Africa, and detailed interviews with experts and learners. Consequently, consensus on this curriculum was sought using a virtual, modified Nominal Group Technique (NGT) over two consensus rounds. A refined course curriculum is proposed.

resultsFourteen expert participants (neonatologists, paediatricians, neonatal nurses, and Advanced Life Support (ALS) providers with ≥ 3 years of experience) allocated potential outcomes to Core, Extended, or Advanced tiers based on EMS scope of practice. A 75% consensus threshold was applied. Eleven experts completed both rounds (21% attrition). Most were ALS providers (43%), largely employed in the public sector (71%). The final curriculum consists of three sequential courses (Core, Extended, Advanced) which scaffolds learning. The Core course consists of five modules, with each curriculum item achieving > 90% agreement on foundational skills including basic assessment, recognition of critical instability, and escalation pathways. This open-access online course is tailored to resource-limited settings.

conclusionA consensus-driven neonatal interfacility transfer curriculum for South Africa was successfully developed, providing a tiered, evidence-based approach to reinforce provider knowledge and confidence. By leveraging expanding internet accessibility, the Bespoke Online NeoNatal Education for Transfers (BONNETs) framework mitigates geographic disparities while integrating best practices for safe neonatal transfer. However, rigorous validation across diverse contexts and attention to broader systemic challenges, is essential to achieving sustained improvements. Future research should assess the curriculum's performance in improving knowledge and confidence, as well as long-term clinical impact on neonatal outcomes.

Indexed as

CurriculumEducation, DistanceNeonatologyPatient TransferConsensusEmergency Medical ServicesHumansInfant, NewbornSouth Africa“Medical Education”“Neonatology”“Patient Transfer”

Identifiers

PMID42289668
PMCPMC13495191

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.