We were dismayed to learn last week that The Lancet, a prominent British medical journal, published a deeply flawed study of an infant simulator-based program that the authors inaccurately associated with RealityworksRealCare Program. The study had nothing to do with us, our curriculum or our RealCare Baby® infant simulators, nor are its conclusions about us credible.

The study has enormous flaws:

1) Our RealCare curriculum spans 14 hours of teaching time, whereas the curriculum used in The Lancet study, without consulting us, is two hours and 20 minutes. That’s not even a Cliff’s Notes version of ours. The curriculum and the infant simulators are an integrated product, just like a computer and software. The RealCare Program involves multiple learning activities, discussion and prolonged take-home simulator experience. You can’t gut the curriculum the way these authors did and expect good performance, or draw any inferences whatsoever about our program. At its most basic, science is supposed to be about comparing apples to apples.

2) The authors somehow failed to mention a key variable that occurred early in the course of the longitudinal study: In 2004, the Australian government introduced its controversial Maternity Payment Program, or “Baby Bonus,” to increase family size.

The program paid a lump sum of $3000 (eventually rising to $5000) to families earning below $75,000 following the birth of a child. Not surprisingly, overall teen pregnancy rates for women from 15-19 years – the same age as those being followed in The Lancet study – rose significantly after years of decline. Before the Baby Bonus was launched in 2004, birth rates for these women were declining steeply, at an average of 4.5% per year. Following the program’s launch, the birth rate for this age group increased 7.7% in 2005 and 13.5% in 2006. Why would one assume the girls in their study group, whose schools were poorer on average than the control group that did not utilize infant simulators, wouldn’t be incentivized by such a sum?

That, to us, is the proverbial hole big enough to accommodate a Mack Truck. Yet the study never mentions the Baby Bonus program or its potential impact on pregnancy rates. That’s astonishing.

3) Magnifying the effect of the above statement, the study groups were not matched. The group who received the infant simulators came from a significantly poorer socioeconomic group than the control group.

What distresses us most about this study, apart from the obvious flaws, is that it confuses a vital public health issue. Our RealCare Program, now used by two-thirds of U.S. school districts, has been adopted in educational institutions since 1995. In that same time frame, teen pregnancy has also declined. There are doubtless many reasons for this, and we believe one is the marked change in attitude toward teen pregnancy and parenting found in RealCare Program participants.

We encourage you to share your experience with the RealCare Program in the comments below.

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