Effect of low-cost interventions on the retention of knowledge and skills following Helping Babies Breathe training

OBJECTIVE To evaluate the impact of a post-Helping Babies Breathe bundle of interventions on the retention of provider-level knowledge and skills. METHOD The present prospective pre-post study following a 1-day Helping Babies Breathe training of professional midwives, physicians, and nurses was conducted in Cajamarca Province, Peru between January 1 and July 31, 2017. The interventions to improve retention included structured worksite practice before every shift, weekly in-service simulated scenarios, and monthly supervised peer-to-peer abbreviated refresher trainings. Knowledge and skills were assessed before, immediately after, and 6 months after training using two validated multiple-choice knowledge test and objective structured clinical examinations (OSCEs; OSCE A and OSCE B). Data were analyzed for changes in knowledge and skills over time and to identify predictors of performance. RESULTS There were 60 learners included. No significant differences were observed between assessments immediately after training and at 6-month follow-up for knowledge scores or time-to-effective-ventilation. Pass rates for OSCE B increased from 83% immediately after training to 95% at follow-up (P=0.007). The only factor associated with a reduced time to effective ventilation at 6-month follow-up was working in a hospital (P