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Table 2 Themes to address in HBB learning and skills maintenance during Phase 1a

From: Development of a novel mobile application, HBB Prompt, with human factors and user-centred design for Helping Babies Breathe skills retention in Uganda

Themes Implications on app development Selected quotes
Peer-to-peer learning Design of rater mode to support group practice through simulation
Scoreboard/Dashboard feature to keep each other accountable for practice
“I see [peer learning] as helpful in the HBB training because most of us don’t go on the same pace. They sit in class together but then find that some pick faster and others nothing at all but when you are together in a health facility…we share what I did not get while someone did, so we learn from our friends”
Supportive supervision “helpful when mentors use checklist while giving feedback—so every person knows where they made mistakes and where to keep learning”
Continuing Medical Education and Refresher courses Repository of HBB information including demonstration videos  
Self-confidence Scoreboard/Dashboard feature to track practice statistics and longitudinal trends of scores on quizzes “I know I can do some good work and since then I have never lost any other baby and I am glad that HBB did some good work”
Timely feedback Use of checklists to help review required steps in HBB after simulation completed
Rater mode to help facilitate peer-to-peer feedback after simulation
“If [you] practice the same thing in and out on your own—may not be as effective as having someone to give you feedback, someone with more experience to give you more input on how to improve”
Safe learning environment Use of audio and visual prompts to facilitate different ways of learning  
Inadequate or inappropriate resuscitation equipment for practice or for clinical use Videos to review choice of and maintenance of resuscitation equipment “We come here to do the training and practice but when we leave this place and go back to our health centres we don’t have what to use. You feel you have the skills, but you don’t have any equipment to use so some of the skills end up dying there.”
Lack of motivation to practice
Too much self-pride
Lack of support from colleagues to practise together, or to acknowledge and support the importance of practice
Scoreboard/Dashboard feature to track practice statistics and results of quizzes to encourage friendly competition and keep each other accountable
Scoreboard/Dashboard to act as a reminder system to encourage ongoing practice
Lack of confidence
Infrequent trainings Videos to review individual HBB skills
Simulation mode to put knowledge and skills together and applying them to simulated delivery scenario
Fear of not knowing how to translate skills from a training setting to real life scenarios Design of simulation mode is to facilitate ongoing practice of skills to best mimic real-life resuscitations