A digital app will be developed to help users communicate well. The app will be developed in a participatory and theory-driven way from all findings and conclusions obtained in Phases 1 and 2 (Fig. 2 ) [66 (link)]. Stages D and E of Phase 1 will be repeated with professionals, expecting mothers/patients, and social support providers to update the evidence and answer questions that may have arisen during Phase 2. The aim of Phase 3 is to determine exactly how the app can support communication between professionals, patients, and their social support providers in their daily work/hospital experience and thereby lead to a reduction in pAEs. As app users will have completed the face-to-face training, they can use the app at their convenience to monitor their behavior and experiences (see Fig. 3 ) and deepen their skills and knowledge. To achieve this aim, there will be two functions of the app.
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3 ). This may enable shared decision making in terms of understanding risks and disadvantages. Furthermore, she is supported to ask the right questions or maybe even audio record her questions and the answers from professionals, as it has been done in previous research [49 (link)]. Regarding b), a doctor may be unsure how to handle the expectant mother’s fear of childbirth and postpartum posttraumatic stress disorder (cf. [67 ]). Typical problems include sharing bad news and dealing with difficult emotions [24 (link), 68 (link), 69 (link)]. The app would help the doctor to communicate accurate information in a way that still addresses the fear that may come along with bad news. This may prevent complications due to insufficient information. Professionals will be asked to analyze and solve scenarios that involve both patients and their social support providers. The app will then explain the communication competences again and give concrete suggestions how to use them for solving the case. Depending on demands, the app will give suggestions such as “Speak slowly”, “Try not to use acronyms or abbreviations”, “Try to refrain from using scientific terms”, “Make use of visualizations”, “Be sensitive to verbal and non-verbal cues that may indicate lack of understanding”, “Stress the most important aspects that the patient must keep in mind”, and “Make use of the teach-back method” [19 (link)]. Regarding c), one team member of the delivery ward knows that a high-risk patient in labor needs prophylactic negative-pressure wound therapy (NPWT) after cesarean delivery, but they do not know how to communicate this to colleagues under time pressure [20 (link)]. The app helps to overcome time pressure by providing a message on the display for the colleagues which can be copied to a piece of paper, and thus support communication [70 (link)]. All of the above cases will be provided to colleagues, who will be asked to analyze and solve them. Communication competences will be explained with regard to communication between colleagues. Depending on demands, specific suggestions such as communication tools (daily goal sheet, bedside whiteboard, or door communication card), trust building, mindfulness, and reflective exercises will be given [71 (link)].
Secondly, the app will assist in monitoring typical or recent communication with focus on (1.) one’s own role, (2.) the role of the communication partner and (3.) resonance (a feeling of mutual understanding), thus supporting the development of general communication competences. These aspects will be evaluated with regard to the communication competences (see Tables1 and 2 ).
Learning from the communication of all participants is ensured by collecting dyadic self-reported data and the partners reported data. Concretely, target-group specific tasks that train general communication competences seldom aid to overcoming specific obstacles, so reminders of resources and application/transfer options will be provided in the app, too.
Example of the monitoring and guidance functions of the app
Secondly, the app will assist in monitoring typical or recent communication with focus on (1.) one’s own role, (2.) the role of the communication partner and (3.) resonance (a feeling of mutual understanding), thus supporting the development of general communication competences. These aspects will be evaluated with regard to the communication competences (see Tables
Learning from the communication of all participants is ensured by collecting dyadic self-reported data and the partners reported data. Concretely, target-group specific tasks that train general communication competences seldom aid to overcoming specific obstacles, so reminders of resources and application/transfer options will be provided in the app, too.
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