In India, community healthcare workers are the primary touchpoints between the state and the beneficiaries, such as pregnant mothers and children. Their healthcare knowledge directly impacts the quality of care they provide through home visits and community activities. Classroom in-person or traditional ways of training are found ineffective in imparting knowledge and render poor knowledge retention, which needs reinforcements through short, frequent revisions. Smartphone games on healthcare topics could be a promising solution as a refresher, as they can be scaled and tailored as per players' requirements. This study aims to check the differences in knowledge gain, pre and post-intervention, and, secondly, to check knowledge retention after six months. 270 CHWs or participants were recruited to evaluate different modes of refresher training and assigned into three equal groups of 90 each. The control group (CG) (n=90) was trained using the standard classroom method, which is usually followed. Intervention Group-1 (IG1)(n=90) was trained in a physical card game format, and Intervention Group-2 (IG2)(n=90) was trained in a smartphone game format. 4 sets of questionnaires were made by shuffling 45 questions based on immunization of equal weightage. The questionnaires were filled out by CHWs by hand and collected, evaluated, and analyzed. Paired t-tests were conducted to compare pre-post knowledge increments and repeated measure ANOVA to check for differences in knowledge retention. Results suggest a significant difference in scores in all three groups. A significant difference was observed between the physical and digital gameplay modes. Pre-post knowledge increment was higher in the digital mode (p<0.05), but knowledge retained was not significantly different (p=.4) in digital and physical card versions.

翻译：在印度，社区医疗工作者是国家与受益人群（如孕妇和儿童）之间的主要接触点。他们的医疗知识直接影响其通过家访和社区活动提供的护理质量。传统的课堂面对面或常规培训方式在知识传授方面效果不佳，且导致知识保留率低，需要借助简短频繁的复习来强化。基于智能手机的医疗类游戏作为一种强化手段极具潜力，因其可规模化并可根据玩家需求进行定制。本研究旨在：首先，检验干预前后知识获取的差异；其次，检验六个月后的知识保留情况。研究招募了270名社区医疗工作者（参与者），用以评估不同形式的强化培训模式，并将其均分为三组，每组90人。对照组（n=90）接受通常采用的标准化课堂培训；干预组1（n=90）接受实体卡牌游戏形式的培训；干预组2（n=90）接受智能手机游戏形式的培训。通过将基于免疫主题的45道等权重题目随机排序，生成了4套问卷。问卷由社区医疗工作者手工填写、收集、评估并进行分析。采用配对t检验比较干预前后的知识增量，采用重复测量方差分析检验知识保留的差异。结果显示，所有三组的得分均存在显著差异。实体游戏与数字游戏模式之间也观察到显著差异。数字模式的干预前后知识增量更高（p<0.05），但数字版与实体卡牌版的知识保留无显著差异（p=0.4）。