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Explanations for Reviewers

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					                                                                           DRAFT 11/22/2010


Design Training Using Resource Package Materials
(Note Beta site users: In the final version of the website, this lead section of the
Facilitator’s Guide to the Training Resource Package will be expanded and combined
with sections on using case studies, role plays, and assessments .)
To develop an effective training program, facilitators need to follow the steps of the
instructional design process, including assessing the learners’ instructional needs and
writing learning objectives. (Materials on this process are available here.) With learning
objectives established, the facilitator can review and select resources and materials from
the modules in the Training Resource Package that address those objectives. A table of
contents is available in Appendix A.
The Training Resource Package modules are each based on a set of performance-based
learning objectives. The activities in each module help participants to achieve the
module’s learning objectives by providing opportunities for them to:
     practice skills
     work with new information or situations
     apply the skills and knowledge they are learning
     receive specific feedback
     monitor and assess their own learning.
The training modules are designed to function as prototype materials that facilitators can
use and adapt into a preservice or inservice curriculum for the particular needs of the
learners. Original source documents are provided as Microsoft Word or PowerPoint files
so materials may be adapted as needed.
Facilitators should also be aware that training by itself will not necessarily address all
factors that affect provider performance. Inservice training interventions are most
effective when developed in the context of a comprehensive performance improvement
effort. For materials on issues related to ensuring provider effectiveness, go here.

Facilitator Prerequisites
The materials in the Training Resource Package are intended to be used by experienced
clinical trainers with a thorough grounding in adult learning principles and a proven
ability to provide clinical training on family planning topics.
Facilitators who need help with designing and conducting training should follow the best
practice guidelines for instructional design and clinical training on the Using the
Resource Package page.

Documents and Resources in Each Module
The following resources and documents are included in each module:
• Session plan
• Primary presentation
• Case studies, role plays, and other activities
• Job aids
• Knowledge and skills assessments
The key documents of every module are the session plan and the primary presentation.

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Session plan
The session plan is the organizing tool that coordinates use of other resources and
documents to achieve module objectives. Module objectives are listed on the first page of
each session plan. The objectives in each module are numbered to facilitate cross-
referencing with other parts of the Training Resource Package. Each section of the
session plan is keyed to one or more slides in the primary presentation.
To make the most effective use of the resource package materials, read the session plan
first, then look at the primary presentation. (Note: The names of files in the session plan
that appear to be links are not active links in this Beta version of the website.)
Primary presentation
The slides and speaker notes in the primary presentations include all of the technical
information that facilitators should convey to trainees. Please read the speaker notes as
you review each primary presentation and any accompanying presentations.
The technical slides are color-coded pale yellow. They present information that complies
with the latest editions of the WHO publications: Family Planning: A Global Handbook
for Providers, the Medical Eligibility Criteria for Contraceptive Use, and the Selected
Practice Recommendations for Contraceptive Use, 2008 update.
To facilitate interactivity and reduce flip chart preparation, discussion questions and
group activities are included in the presentation as activity slides. These slides are color-
coded with an orange background. Instructions for conducting the group activities are in
the speaker notes for these slides or if necessary, in a separate file (e.g., games).
To facilitate use in preservice settings, some of the primary presentations include
advanced slides, which have a pale blue background. These slides present research
studies that support the conclusions and summaries presented in the Global Handbook
and the Training Resource Package. These can be included or excluded by the facilitator
as appropriate for the participants and the training objectives.
Case studies and role plays
The method-specific modules include case studies and/or role plays. Each case study has
three to five sets of progressive case descriptions, with accompanying questions and
answer keys. Role plays include four or five realistic scenarios, with separate information
sheets for the client and observer roles for each scenario. These activities are highly
interactive and can be used for both large and small groups.
Job aids
Modules include job aids that describe how and when to perform important provider
tasks. Learning activities in the modules give participants opportunities to practice using
these job aids so they can more easily incorporate use of these tools at their worksite.
Assessments
Modules for clinical providers include both knowledge and skills assessments. Modules
for CHWs include skills assessments.




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Using the Materials for Inservice Training
For inservice training programs, facilitators may adapt session plans for use as course
outlines, selecting objectives and activities according to their training plan. Facilitators should
also develop and distribute a training schedule that includes daily warm-ups and wrap-ups
(which are not included in the session plans) and starting and ending times of daily activities.
Links to a collection of warm-ups and wrap-ups are available on the Using the Resource
Package page. An example of a schedule that could be used to train experienced community
health workers (CHWs) tasked with providing progestin-only injectables, in addition to the
services and methods they already offer, is included below in Appendix C.
With the exception of training CHWs to give injections, the Training Resource Package
does not provide resources for training providers in clinical procedures, because clinical
training resources are currently available online. To give users easy access to these
resources, the Training Resource Package includes links to existing materials for clinical
procedures training in the session plans.
Rather than endorse a particular counseling approach or tool, the Training Resource
Package offers activities that can be used with a variety of counseling approaches and job
aids. The term, Counseling Tool in the Training Resource Package materials may refer to
WHO’s Decision-Making Tool for Family Planning Clients and Providers, the Balanced
Counseling Strategy, or other approaches and tools. Facilitators should use the counseling
tool that training participants are using (or will use) at the work site after the training
intervention.
Core Modules for Clinicians and CHWs
The core modules support the development of foundational skills necessary for the
provision of family planning services. Core modules for clinicians include:
• Factors that Affect FP Method Choice
• Introduction to WHO’s Medical Eligibility Criteria for Contraceptive Use
• Benefits of FP
• FP Services Overview
• Conducting Socio-Medical Histories
• Infection Prevention Practices for FP Services
• Physical Assessments (FP method or RH problem)
• FP/RH Counseling (content/process)
Core modules for CHWs include:
• Benefits of FP
• Role of CHWs in FP Service Provision
• Characteristics of FP Methods
• Factors that Affect FP Method Choice
• Menstrual Cycle/Fertile Period
• Record Keeping (clients and commodities)
• FP/RH Counseling (content/process)
• Identification and Referral
These modules are designed to achieve the core learning objectives for clinicians and
community health workers, which are listed below in Appendix B.


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Appendix A: Training Resource Package Table of Contents
This table of contents provides an overview of the resources and documents in the Training Resource Package:

                           A Training Resource Package for Family Planning
                                                                Table of Contents
Using the Resource Package              Training Clinical Providers           Training CHWs                         Ensuring Provider Effectiveness
Facilitator’s Guide to the Training     Core Skills Modules (see Appendix B   Core Skills Modules (see Appendix B   Applying Learning:
Resource Package                        for complete list)                    for complete list)                    A Systems Approach
 • Design training using materials in   Method-Specific Modules:              Method-Specific Modules:               • Enabling Factors
   the modules
                                        • Condoms (Male and Female)           • Condoms (Male and Female)            • Guidance for Applying Learning
 • Conduct role plays                                                                                                  Using a Systems Approach
                                        • Combined Oral Contraceptives        • Combined Oral Contraceptives
 • Use case studies                        (COCs)                                (COCs)
                                                                                                                       o Key Strategies
 • Score and use knowledge                                                                                             o Sample Case Studies and
                                        • Progestin-Only Injectable           • Progestin-Only Injectable                 Team Action Plans
   assessment results                      Contraceptives                        Contraceptives
 • Acronyms list                                                                                                       o Matrix of Team Member
                                        • Progestin-Only Implants             • Standard Days Method® (SDM)               Activities and Responsibilities
Best practice guidance:                 • Intrauterine Devices (IUDs)         • Lactational Amenorrhea Method
 • FP/RH provider competencies          • Male Sterilization                     (LAM)                              • Additional Resources by Topic
   (WHO)                                • Female Sterilization                • TwoDay Method®                         Area
 • Instructional design                 • Standard Days Method® (SDM)         • Emergency Contraception
 • Clinical training skills             • Lactational Amenorrhea Method
                                           (LAM)
                                        • TwoDay Method®
                                        • Emergency Contraception




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Appendix B:
Core Objectives for Clinicians*

Trainees will be able to:
1.1 Describe the factors that affect contraceptive method choice (e.g., fertility intentions, cost,
     previous method experience, resupply access)
1.2 Explain the rationale for the Medical Eligibility Criteria for Contraceptive Use
     developed by WHO and how they are applied
1.3 Explain the health benefits of family planning for the mother, children, families, and
     community in a manner that clients and community members can understand (e.g.,
     HTSP, economic)
1.4 Explain the individual and public health benefits of offering a broad contraceptive
     method mix and offering FP services in a variety of settings by different types of
     providers (i.e., community distribution by nonclinical providers)
1.5 Obtain and record relevant aspects of FP clients’ socio-medical histories (e.g.
     number of pregnancies, FP/RH goals, STI risk, BP)
1.6 Describe or demonstrate (when feasible) appropriate infection prevention practices
     while providing FP services
1.7 Perform relevant components of physical assessments depending on the client’s
     selected FP method or health problem
1.8 Describe the process and content of counseling sessions for clients seeking FP services
     (e.g., Balanced Counseling Strategy, risk assessment)
1.9 Demonstrate the ability to offer informed choice family planning counseling to
     clients during role-play simulations while addressing reproductive health issues
     relevant to the clients described in the scenario (or when feasible, actual clients).
* Depending on the trainee’s scope of practice, these objectives address knowledge/skills that are
  prerequisites for the method-specific objectives.




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Core Objectives for Community Health Workers (CHWs)*

Trainees will be able to:
1.1 Explain the health benefits of family planning (FP) for mothers, children, families, and
     communities (e.g., health benefits of spacing, economic benefits).
1.2 Explain their role in providing community-based access to FP and describe the potential
     benefits and challenges.
1.3 Present an overview of the characteristics of all available methods offered – either
     through community-based access or referral.
1.4 Describe the factors that affect contraceptive method choice (e.g., fertility intentions,
     cost, previous method experience, resupply access).
1.5 Describe the how and when pregnancy occurs in a manner understood by clients (e.g.,
     simplified explanation of fertile time and fertilization).
1.6 Obtain and record relevant aspects of FP clients’ socio-medical histories (e.g. # of
     pregnancies, health concerns) and track and report services provided and commodities
     dispensed.
1.7 Describe the process and content of counseling sessions for clients seeking FP services.
1.8 Demonstrate the ability to offer informed choice FP counseling to clients during role-
     play simulations while addressing reproductive health issues relevant to the clients
     described in the scenario (or when feasible, actual clients).
1.9 Identify clients in need of referral for health problems or methods that are not provided
     at the community level.
*   Depending on the trainee’s scope of practice, these objectives address knowledge/skills that are
    prerequisites for the method-specific objectives.




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 Appendix C: Sample Schedule for Training Experienced CHWs to Provide Progestin-Only Injectables
Time           Day 1 (~6¼ hours)                   Day 2 (~6 hours)                   Day 3 (~6¼ hours)                     Day 4 (~ 5¾ hours)             Day 5 (~4¼ hours)
8:30-9:00 or   Welcome / Introductions             Review Agenda / Warm-Up            Review Agenda / Warm-Up               Review Agenda / Warm-Up
start of day   30 minutes                          30 minutes                         30 minutes                            30 minutes

               A. Overview of Objectives and       H. Giving Practice Injections to   L. Conducting Reinjection Visits     O. Role Playing (continued)     Practicum (continued)
Early
               Reflection 30 minutes               Fruit/                             60 minutes – Overview, Practice with 90 minutes – Practice Case      90 minutes – Observation, Feedback
morning
               B. Characteristics of Injectables   60 minutes – Work in Pairs         Job Aid                                                              2 clients
session
               35 minutes

Break          BREAK – 15 minutes                  BREAK – 15 minutes                 BREAK – 15 minutes                    BREAK – 15 minutes             BREAK – 15 minutes

               C. Why Women Like/Dislike           H. Giving Practice Injections      M. Record-keeping                     P. Practicum Orientation       Practicum (continued)
               Injectables 30 minutes –            (continued)                        60 minutes – Overview, Practice       30 minutes – Review, Discuss   90 minutes – Observation, Feedback
Late
               Brainstorm, Present, Discuss        60 minutes – Work in Pairs         Form Filling                          Expectations                   2 clients
morning
               D. Who Can or Should Not Use                                                                                 Q. Distribute Supplies and
session
               Injectables 40 minutes –                                                                                     Equipment
               Presentation/Checklist Practice                                                                              60 minutes – Review CHW Kits

!2:30 p        LUNCH – 60 minutes                  LUNCH – 60 minutes                 LUNCH – 60 minutes                    LUNCH – 60 minutes             LUNCH – 60 minutes

               E. Injection Demonstration          I. Counseling about Injectables    N. Injectables Fun Facts Game         Practicum                      COURSE WRAP-UP
               45 minutes – Demonstrate, Present   60 minutes – Present, Work in      45 minutes – Team Activity            60 minutes – Observation,
Early          F. Needle Safety/Accidental         Pairs                                                                    Feedback 1 client
afternoon      Needle Stick                        J. Determining the Reinjection
session        30 minutes – Demonstrate, Present   Date
                                                   30 minutes – Present, Group                                          * This course schedule allots time to conduct all
                                                   Activity                                                               the activities that address the learning objectives
                                                                                                                          specific to provision of injectables by CHWs. In
Break          BREAK – 15 minutes                  BREAK – 15 minutes                 BREAK – 15 minutes                  this situation, the experienced CHWs have all the
                                                                                                                          necessary prerequisite skills. If participants do
               G. Finding Injection Site on Arm    K. Conducting Client Visits        O. Role Playing
Late                                                                                                                      not have the foundational skills addressed in the
               and Hip                             30 minutes – Discuss               90 minutes – Practice Case
afternoon                                                                                                                 core objectives for CHWs, the training
               45 minutes – Demo, Practice with
session                                                                                                                   intervention must be expanded to incorporate
               Partner
                                                                                                                          activities that address those deficits. The core
4:30 – 5:00    DAILY WRAP-UP                       DAILY WRAP-UP                      DAILY WRAP-UP                       skills must be developed prior to learning
               Assigned Reading – review first     Assigned Reading – review                                              method-specific skills.
               half of flip book                   second half of flip book

 (Note: Additional sample training schedules that address other common sets of FP learning objectives will be included in the final
 version of the Training Resource Package website.)



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