Interpersonal Communication Skills for Differential Diagnosis of Fever in Children

Transcription

1 Interpersonal Communication Skills for Differential Diagnosis of Fever in Children National Master Trainer TOT Guide for training District Trainers Uganda July, 2013

2 TOT Guide Page 2

3 About this TOT Guide This TOT Guide is intended to be used by the Uganda National Master Trainers to conduct training of approximately 72 District Trainers over a 2.5 day TOT. During the TOT, District Trainers will learn how to prepare, deliver and evaluate the training of health of training health providers at all levels of public health facilities on Interpersonal Communication Skills for the Differential Diagnosis of Fever in Children. This TOT Guide is to be used along with the TOT Handouts and the Trainer Guide. Table of Contents About this TOT Guide... 3 Table of Contents... 3 Preparing for District Trainer TOT Checklist... 4 Training Materials Needed for TOT... 4 TOT Learning Objectives... 5 TOT Agenda... 6 Session One Introduction to TOT... 8 Session Two Adult Learning Session Three Intro to IPC Skills Health Provider Training Session Four Intro to Facilitation Practice Session Five Trainer Demonstration Practice Session Six Planning for TOTs and Health Provider Trainings Session Seven Evaluating Health Provider Trainings Session Eight Close of TOT TOT Guide Page 3

4 Preparing for District Trainer TOT Checklist Read and understand the content of the TOT Guide. Read and understand all the materials that will be used for the TOT. Read and understand the District Trainer roles and responsibilities and the District Trainer Competencies. Prepare a list of District Trainers with their names and contact information. Secure a location to deliver the 2.5-day TOT. Invite the District Trainers to the TOT. Inform them of the agenda and learning objectives. Prepare all the needed materials and resources to conduct all the activities on the TOT agenda. Training Materials Needed for TOT The TOT facilitator will need to prepare the following materials for each TOT. Item Quantity 1. TOT Guide 1 per Master Trainer 2. District Trainer TOT Handouts: 1 per District Trainer 3. Managing Challenging Participants Handout 1 per District Trainer 4. TOT Training Attendance Register 1 5. Trainer Guide 6. Health Provider Workbook 7. Job Aid for Children with Fever 1 per Master Trainer 1 per District Trainer 1 per Master Trainer 1 per District Trainer 1 per Master Trainer 1 per District Trainer 8. Health Provider Pre-Test 1 per District Trainer 9. Certificate of Attendance 1 per District Trainer 10. Flipchart paper 2 reams 11. Marking pens 1 box 12. Notebooks and pens 1 per District Trainer 13. Camera Optional 14. Prizes Optional TOT Guide Page 4

5 TOT Learning Objectives At the completion of the TOT, the District Trainers will be able to: Describe the purpose and activities of the Test & Treat Campaign. Plan for the health provider trainings. Prepare in advance for each health provider training with the correct quantity of all of the training resources and materials. Deliver the 2-day health provider training on IPC Skills for Differential Diagnosis of Childhood Fever. Give health providers accurate information about malaria testing and IPC skills. Explain and demonstrate interpersonal communication skills to health providers. Use the Job Aid for Children with Fever as a teaching tool and show the health providers how to use it in the health facility. Demonstrate trust in malaria test results by only treating malaria based on positive test results rather than presumptive diagnosis. Explain the implications of non-adherence to negative malaria tests. Give clear instructions during training and verify the health providers understand how to complete each training activity. Manage time during each health provider training by starting and ending on time and completing all the training activities outlined in the Trainer Guide. Keep the health providers attentive, involved, and engaged during training. Give the health providers constructive feedback during training to motivate and improve their performance. Evaluate the impact and effectiveness of each health provider training by reviewing the results of the Pre- and Post-Tests and the training evaluation form. Complete the Training Report at the end of each TOT and health provider training. Conduct three support supervision visits at the health facilities to ensure health providers are applying what they learned during training. TOT Guide Page 5

6 TOT Agenda DAY 1 Session 1 Introduction to TOT (90 min) Official Opening Pre-Test Icebreaker Expectations for TOT TOT Learning Objectives and Agenda Ground Rules Introduction to Test & Treat Campaign Debrief Session 1 Module 1 of the Trainer Guide Session 2 Adult Learning (2.5 hours) Trainer Roles and Responsibilities Introduction to Trainer Competencies Managing Challenging Participants Session 3 Introduction to IPC Skills Health Provider Training (90-min) How to Use the Trainer Guide Introduction to the Job Aid Introduction to Handout 5A Common Signs and Symptoms &Treatment Session 4 Introduction to Facilitation Practice (2 hours) Demonstration of Module 2 IPC Skills Debrief Module 2 Preparation for District Trainer Practice TOT Guide Page 6

7 DAY 2 Session 5 Trainer Demonstration Practice of Modules 3, 4, 5 and 6 Module 3 TG Training Practice and Feedback Module 4 TG Training Practice and Feedback Module 5 TG Training Practice and Feedback Module 6 TG Training Practice and Feedback DAY 3 (1/2 day) Session 6 Planning for District Trainer TOTs and Health Provider Trainings (45 min) Health Provider Training Schedule Preparing for Health Provider Trainings Session 7 Evaluating Health Provider Trainings (2.5 hours) Pre- and Post-Test and Scoring Sheet and Planning CMEs Evaluation Summary Sheet Completing Training Reports Supervision Checklist Session 8 Close of TOT (30 min) TOT Evaluation TOT Certificates TOT Guide Page 7

8 DAY 1 Session One Introduction to TOT Time: 90 min Materials: TOT Attendance Register (1) Health provider Pre-Test (1 for each DT) District Trainer TOT Handouts (1 for each DT) Pens and notebooks (1 for each DT) Flipchart paper and markers Registration and Official Opening 1. Complete the TOT Attendance Register for Day Welcome District Trainers (DTs) to the TOT. 3. Introduce any official guests. 4. Introduce the National Master Trainers and give a brief description of their professional background. 5. Officially open the TOT. Pre-Test 1. Explain the purpose of the Pre-Test and how it will be used during the health facility trainings. 2. Explain that the DTs will be taking the Pre-Test so that they will experience how to answer the questions and can explain them to the health providers during the trainings. 3. Explain that you will NOT be giving a Post-Test on the last day of TOT because they will have the answer key in their Trainer Guide. 4. Distribute the Pre-Test and a writing pen to each DT and allow minutes to work on their own to complete. 5. Collect the Pre-Tests when they are finished. Save the Pre-Tests for the last day of TOT in order for the DTs to score them and learn how to use the complete the Test Score Tracking Sheet. Icebreaker 1. Ensure each DT has a pen and notebook. 2. Divide DTs into groups of 3 to 4 people. 3. Ask each group to share the following information with each other: TOT Guide Page 8

9 Where they are from Current job title Years of experience training others What they know about IPC with patients and caregivers Favourite song 4. Allow 5 minutes. 5. Gather the attention of the small groups and ask them to tally the cumulative number of years of training experience they have in their group. Allow 1 minute. 6. Gather attention of small groups and ask each group to share the total years of training experience. 7. Write the years of experience on a flipchart. 8. Tally up ALL the years and say: In this room we have a cumulative XX years of training experience. Let s take advantage of sharing our experiences and what we know about training adults with each other during the next 2.5 days. Expectations for TOT 1. In the same small groups ask each group to nominate a group leader. 2. Give each leader a piece of flipchart paper and a marking pen. 3. Assign the leader to write down what each DT expects to learn during the TOT. 4. Allow 5 minutes for discussion. 5. Invite each group leader to present their group s expectations in 2 minutes or less. 6. Monitor time strictly. TOT Agenda and Learning Objectives 1. Distribute the District Trainer TOT Handouts to each DT. 2. Explain the District Trainer TOT Handouts contain information and worksheets the DTs will use during the TOT. 3. Ask the DTs to find the TOT Learning Objectives and TOT Agenda in their handouts and review them. 4. Explain where their expectations will be met. Clarify any expectations that are not in line with what the TOT will cover. 5. Ensure the following information is explained: Each DT will be getting a Trainer Guide later in the day which contains all the information and instructions they will need to train health providers on IPC Skills for Differential Diagnosis of Fever in Children. TOT Guide Page 9

10 The Trainer Guide contains 6 modules that will be used to train a group of approximately 20 health providers over 2 days. The National Master Trainers will demonstrate how to train Modules 1 and 2. The DTs will work in teams to train Module 3-6 using the Trainer Guide. The start and finish times for each day of TOT and the importance of arriving to training on time. Day 3 of the TOT will focus on planning and logistics of preparing, implementing, and evaluating the health provider health provider trainings. The National Master Trainers will attend the first health provider training to provide support and supervision. Administrative and logistic information including meals, lodging and per diem. Ground Rules 1. Ask the DTs what the purpose of having ground rules is. Accept all reasonable answers. 2. Invite DTs to contribute the ground rules they would like to have during TOT and gain consensus from the group. 3. Invite a DT to write the ground rules on a flipchart and post flipchart in room for duration of training. Introduction to the Test & Treat Campaign 1. Ask the DTs to share what they know so far about the Test & Treat Campaign. 2. Explain the following content: MOH policy requires parasite-based diagnosis of malaria by microscopy or RDTs before treating, and only treating those with a positive malaria test results with ACTs. Many children are still getting anti-malarial medicines without confirmation of malaria. The NMCP is supporting the campaign to educate the public and health providers to test all fever cases for malaria, rather than treating all fevers as malaria. The aim of the campaign is to: - build trust in malaria test results among clients and public health providers; - increase the proportion of clients with a fever who are tested and treated appropriately; - encourage community members to test for malaria before treating. The campaign consists of training health providers at HCII, HCIII, HCIV and regional hospitals. TOT Guide Page 10

11 The campaign also consists of mass media communication and messages about the new policy to the public and orientation to district leadership and VHTs. 3. Explain that as much as the trainers and the health provider will be learning new information during this training, they will also be unlearning old information and this can sometimes be challenging to adapt to. Make the following points: Health care is dynamic always changing based on new scientific evidence. The old paradigm was treat all fevers as malaria. That was before accurate and reliable RDTs became widely available and laboratory diagnosis by microscopy was limited to few health facilities. New evidence shows that malaria is not as prevalent as it used to be and there are other childhood febrile illnesses that are not being treated because of presumptive diagnosis of malaria. 4. Encourage DTs to keep an open mind to new information in order to improve the care of children with fever. 5. Ask the DTs if they have any questions and provide clarification. Debrief Session 1 1. Explain that you have just demonstrated how to facilitate Module One of the Trainer Guide. DTs will conduct the same training activities when training the health providers. 2. Debrief the activities from Session 1 by reviewing the purpose of a pre-test, an opener, icebreaker and establishing ground rules. 3. Ask which adult learning principle is used in Module One. Adults learn best when they know how the training will help them be better at a skill or their job. TOT Guide Page 11

12 Session Two Adult Learning Time: 2.5 hours Materials: District Trainer Competencies (in DT Handouts) Managing Challenging Participants Worksheet (in DT Handouts) Managing Challenging Participants Handout (1 for each DT) Trainer Roles and Responsibilities 1. Review the following DT Roles and Responsibilities (which are also listed in the Trainer Guide) and gain their agreement. Attend and participate fully during the ToT. Prepare for all health provider trainings in advance. Ensure the correct quantity of all of the training resources and materials are available throughout the training. Follow the steps in the Trainer Guide correctly and deliver the content using adult learning and participatory facilitation skills. Give the health providers correct information and verify the health providers understand the content. Use the Job Aid for Children with Fever as a teaching tool and show the health providers how to use it with caregivers and patients. Manage the time during training by starting and ending on time and completing all the training activities outlined in the Trainer Guide. Keep the health providers attentive, involved, and engaged during training. Give clear instructions for training activities. Give health providers feedback on their performance using the Competency Performance Assessment Checklist. Implement the Pre- and Post-tests and evaluate each training. Complete a training report after each training and submit it to SMP. Introduction to Trainer Competencies 1. Ask DTs, What are competencies? Competencies are integrated sets of knowledge, skills, abilities, and attitudes that help define a specific level of performance; to a specific standard; for specified circumstances. 2. Ask DTs to find the District Trainer Competencies in their handouts. TOT Guide Page 12

13 3. Describe the difference between the 4 proficiency levels (advanced, satisfactory, basic, and unsatisfactory) and how they will be used to evaluate the District Trainers and provide feedback to reward and improve performance. 4. Review the 7 District Trainer Competencies and give examples of how the proficiency levels differ. 5. Review the purpose and scoring of the District Trainer Performance Appraisal Summary Sheet. 6. Explain that the Master Trainers will be using the competency checklist as a guide to observe and evaluate how well the District Trainers train during the practice sessions on Day 2 and when they train the health providers. Managing Diverse and Difficult Participants 1. Ask DTs to share their experience has been training challenging or difficult participants. 2. Record responses on the flipchart. 3. Explain that the purpose of this session is to identify common challenging participants they may find in training and discuss solutions for managing them. 4. Explain that unless the participant has personality issues, most of the time the challenging participants can either be avoided or managed by knowing the audience and using adult learning principles. 5. Ask the DTs to find the Managing Challenging Participants Worksheet in their handouts. 6. Review the list of challenging participants and their descriptions. 7. Ask participants to select the top 10 they want to discuss. 8. Divide the DTs into 5 groups, 9. Assign each group 2 types of challenging participants and ask them to complete the 2 columns in their worksheet based on their experience: possible reasons and how to manage. 10. Allow 15 minutes. 11. Invite each pair to present the outcome of their discussion and seed additional information as needed from others and if needed as the facilitator. 12. After all groups have shared, distribute the handout with the answers and briefly review the content TOT Guide Page 13

14 Session Three Intro to IPC Skills Health Provider Training Time: 90 min Materials: Trainer Guide (1 for each DT) Health Provider Workbook (1 for each DT) Job Aid (1 for each DT) Handout 5A Common Signs & Symptoms and Treatment Handout (1 for each DT) How to Use the Trainer Guide 1. Distribute the Trainer Guide to each DT. 2. Explain the Trainer Guide is theirs and suggest they write their name on it. 3. Explain that they can write notes in the guide if it will help them to remember instructions. 4. Divide the DTs into pairs and ask them to review the Trainer Guide together. 5. Ask each group to do the following: Find how many sections the Trainer Guide is divided into and describe each section. Find how many modules are in each section Name the modules and describe how they are laid out Make a list of 10 other things in they find in the Trainer Guide. 6. Allow 15 minutes. 7. Gather the DTs attention. 8. Review and explain the following about the Trainer Guide: There is a Table of Contents. There are multiple references to page numbers throughout. There are 6 sections to this Trainer Guide: 1. Test & Treat Overview contains background information about the Test & Treat Campaign. 2. Training Overview contains information about how to prepare for, implement, and evaluate training of health providers. Contains the training cascade, responsibilities, list of materials and other trainer checklists, the learning objectives and agenda, how to implement and score Pre- and Post-tests, and how TOT Guide Page 14

15 to write the Training Report. It also includes information on Adult Learning Techniques 3. Technical Information for Trainers contains background information on IPC skills and differential diagnosis of common febrile illnesses in children under-5. Trainers should read and fully understand the content of this section before training, and be able to apply the content during the trainings. Contains a glossary and background information on IPC skills, assessment of danger signs, differential diagnosis of common febrile illnesses in children under 5 and information on RDTs. 4. Trainer Instructions contains a step-by-step guide to deliver the training content in a systematic and consistent manner using adult training methodology. a. Annex A contains copies of the Health Provider Workbook the health provider will receive. Each handout is numbered in sequence according to the module number. b. Annex B contains the Trainer Materials the trainer will use to deliver and evaluate the training such as forms and answer keys to activities. 9. Explain that their homework tonight will be to read and learn the content of the Technical Information for Trainers section (pages 27-50). 10. Explain how the format each module organized. Refer to the How to Follow the Trainer Instructions (page 52)> There is a header to identify each module. The table at the beginning of each module. Page number references. Meaning of bulleted lists in the shaded area. Meaning of words in italics. Meaning of Trainer Notes. 11. Describe the content of the 6 modules. 12. Review and explain the contents of Annex B. 13. Explain that each health provider will get a Health Provider Workbook during training that contains worksheets and case scenarios for training activities. 14. Show the workbook and explain that the same content can be found in the Annex A of their Trainer Guide (pages 79-95). 15. Explain that as they demonstrate Modules 3 through 6 tomorrow they will become familiar with Trainer Guide and how to use it. 16. Remind them of their homework. Introduction to the Job Aid 1. Give each DT the Job Aid for Children with Fever. TOT Guide Page 15

16 2. Explain that each health provider will get a Job Aid during training and it will be important for trainers to train them how to use it effectively 3. Ask DTs to review the Job Aid. 4. Invite 1 or 2 DTs to explain the purpose of the Job Aid and review how it will be used. The Job Aid for Children with Fever is an interactive tool to help health providers apply the interpersonal communications skills with caregivers of children under 5 during assessment, diagnosis and treatment of fever. The Job Aid is to be used in the health facility with caregivers by showing the caregiver the pictures on the front of each card while following the cues on the back of each card. Each card follows the process of: Taking a patient history Assessment of danger signs Examining the child Communicating the need to test for malaria and the testing procedure Communicating positive malaria test results and treatment Communicating negative malaria test results Communicating how to care for a child with fever Introduction to Common Signs & Symptoms and Treatment Handout 1. Give each DT a copy of Handout 5A Common Signs & Symptoms and Treatment Handout. 2. Explain the purpose of the handout and how and when it will be used with the health provider Common Signs and Symptoms of Febrile Illness Worksheet in the Health Provider Workbook. TOT Guide Page 16

17 Session Four Intro to Facilitation Practice Time: 2 hours Materials: Trainer Guide Health Provider Workbook Job Aid Module 2 materials Demonstration of Module Two 1. Explain that you will be demonstrating how to use the Trainer Guide and how to train health providers by training Module Two Interpersonal Communication Skills of the Trainer Guide. 2. Ask the DTs that during the demonstration you would like them to follow along in the Trainer Guide as well as participate as trainees (health providers). 3. Explain the contents of the table at the beginning of the module and show the DTs each of the materials you have prepared ahead of time. 4. Show how you have prepared to train for Module Two by completing all the preparation steps. 5. Follow the Trainer Guide and deliver the entire module to the DTs. When there are activities that the health providers are expected to complete, such as filling out forms or small group discussion, have the DTs do the activities so they can learn and practice the content. 6. You may need to stop to explain some of the content or process to the DTs. 7. Debrief the training process after you have completed training the module. 8. Answer any clarifying questions the DTs may have. Preparation for Training Practice 1. Explain that tomorrow it will be the DTs turn to facilitate Modules 3, 4, 5, and 6 to each other. 2. Provide the following instructions for how to prepare for their Training Practice sessions. DTs will each need to train a portion from Modules 3, 4, 5, or 6. Even though DTs are responsible for only one portion of the module, it is important to read and understand the entire module so they understand the module objectives and context. They will need to determine and obtain (before they leave for today), the training materials they will need to facilitate their section of the module. TOT Guide Page 17

18 Remind them to look in Annex A for copies of the Health Provider Workbook materials. It will be important to know who is training the sessions before and after in order to coordinate. When the DTs are not training they will pretend to be the health providers. It is okay, and encouraged to use and refer to the Trainer Guide while they are training. There will be a feedback session after the entire module has been delivered, not after each trainer. This is a time management saver. TOT facilitators will use the District Trainer Competencies to provide feedback on the DTs training practice. 3. Assign the DTs their module assignments and instruct them to begin preparing. 4. Provide assistance as needed. 5. Close Day 1 by reminding the DTs of their homework (to read the TG section on Technical Information for Trainers) and reminding them of the starting times and to arrive on time. TOT Guide Page 18

19 DAY 2 Session Five Trainer Demonstration Practice Time: all day Materials: Trainer Guide Health Provider Workbook Job Aid District Trainer Competency Checklist Welcome and Training Quiz 1. Complete the Daily TOT Training Attendance Register for Day Ask DTs to raise their hands if they did their homework and read the sections in their trainer guide. 3. Make note of those who did not raise their hand. 4. Ask the following questions from the Technical Information for Trainers section of the Trainer Guide to reinforce the DTs understanding of the content. Why is it important to train health providers to practice IPC skills with patients and caregivers? What are the febrile illnesses that will be reviewed in the health provider training? What is the leading cause of death among children under five in Uganda? What is one benefit of RDT? What is one limitation of RDTs? Module 3 TG Training Practice 1. Invite the DTs training Module 3 to stand in the order of the module sections so that the module can be delivered sequentially. 2. Ask the first DT to introduce Module 3 by reviewing purpose and objectives as well as the duration and preparation needed. 3. Allow the entire module to be delivered. Avoid interrupting to make corrections unless necessary. 4. Observe each DT. 5. Make notes of various DTs performance using the District Trainer Competency Checklist. TOT Guide Page 19

20 6. Provide general feedback to the entire group of DTs that trained Module 3 after the entire module has been delivered. Begin by giving praise for what you observed was done well in terms of the competencies. Invite the other DTs to provide feedback about the competencies performed well. Conclude by congratulating them for being the first to train and with the least amount of timer for preparation. 7. Invite individual DTs to meet with you after training to provide individual constructive feedback as needed. Module 4 TG Training Practice 1. Invite the DTs training Module 4 to stand in the order of the module sections so that the module can be delivered sequentially. 2. Ask the first DT to introduce Module 4 by reviewing purpose and objectives as well as the duration and preparation needed. 3. Allow the entire module to be delivered. Avoid interrupting to make corrections unless necessary. 4. Observe each DT. 5. Make notes of various DTs performance using the District Trainer Competency Checklist. 6. Provide general feedback to the entire group of DTs that trained Module 4 after the entire module has been delivered. Begin by giving praise for what you observed was done well in terms of the competencies. Invite the other DTs to provide feedback about the competencies performed well. 7. Invite individual DTs to meet with you after training to provide individual constructive feedback as needed. Module 5 TG Training Practice 1. Invite the DTs training Module 5 to stand in the order of the module sections so that the module can be delivered sequentially. 2. Ask the first DT to introduce Module 5 by reviewing purpose and objectives as well as the duration and preparation needed. 3. Allow the entire module to be delivered. Avoid interrupting to make corrections unless necessary. 4. Observe each DT. 5. Make notes of various DTs performance using the District Trainer Competency Checklist. TOT Guide Page 20

21 6. Provide general feedback to the entire group of DTs that trained Module 5 after the entire module has been delivered. Begin by giving praise for what you observed was done well in terms of the competencies. Invite the other DTs to provide feedback about the competencies performed well. 7. Invite individual DTs to meet with you after training to provide individual constructive feedback as needed. Module 6 TG Training Practice 1. Invite the DTs training Module 6 to stand in the order of the module sections so that the module can be delivered sequentially. 2. Ask the first DT to introduce Module 6 by reviewing purpose and objectives as well as the duration and preparation needed. 3. Allow the entire module to be delivered. Avoid interrupting to make corrections unless necessary. 4. Observe each DT. 5. Make notes of various DTs performance using the District Trainer Competency Checklist. 6. Provide general feedback to the entire group of DTs that trained Module 6 after the entire module has been delivered. 7. Invite individual DTs to meet with you after training to provide individual constructive feedback as needed. 8. Thank participants for their participation. Review the agenda for Day 3. Remind DTs of the starting times and to arrive on time. 9. Close Day 2. TOT Guide Page 21

22 DAY 3 Session Six Planning for TOTs and Health Provider Trainings Time: 45 min Materials: Training Cascade in the Trainer August Guide 2013 Flipchart with Training Schedule Sun Mon Tue Wed Thu Fri Sat Training Schedule Master Trainer TOT (2.5 days) 1. Complete the TOT Attendance Register for Day Pre-testing 1 Health Provider Training (2 days) 2. Review the Training Cascade on page 6 of the Trainer Guide. NMCP and CCP review of 1 st edition of Training Materials Discuss the number of District Trainers and health providers per training. Incorporate changes from pre-testing and NMCP 4. Discuss when the health facility supervision visits will take place (not why and how that is discussed in Session 7) Printing of materials, distribution and planning 3 TOTs and 14 HP trainings with Master Trainers 5. Review the Training Schedule on the flipchart you have prepared District Trainer TOT s (2.5 days each) September Health Provider Trainings (2 days each) Health Provider Trainings (2 days each) Preparing for Trainings 1. Divide DTs into small groups to discuss each step of the Preparing for Training Checklist and Trainer Materials Needed on page 11 in the Trainer Guide. 2. Allow 10 minutes. 3. Facilitate a discussions for how to plan for the Health Provider Trainers including which HPs will be invited and determining the location and training venue. 4. Discuss lodging and transportation 5. Explain how the DTs will obtain the training materials from SMP before each training. 6. Ask the same small groups groups to discuss each step of the First Day of Training Checklist on page 12 in the Trainer Guide. TOT Guide Page 22

23 Session Seven Evaluating Health Provider Trainings Time: 2.5 hours Materials: Trainer Guide Pre-Tests completed by the DTs. Pre-Test Answer Key in the Trainer Guide Test Score Tracking Sheet Health Provider Training Evaluation Form Training Evaluation Summary Template Training Report Template Health Facility Support Supervision Checklist Handout Pre- and Post-Test and Scoring Sheet and Planning CMEs 1. Review the Instructions for Administering Pre- and Post-Test on page 13 and 14 of the Trainer Guide. 2. Explain the following: The purpose of the Pre-test is to determine existing knowledge of health providers and where gaps exist. The tests are divided into 4 sections: Interpersonal Communication Assessment of fever Diagnosis of malaria Differential Diagnosis of fever Both test have same questions and answers, but in different order. The answer keys to both tests are in Annex B of the Trainer Guide. Explain that the Pre- and Post-Test will be provided to the District Trainers and District before each training. Information at the top must be written on the top of every page in case the pages get seperated. Completed Pre- and Post-Tests must be collected, scored and archived for evaluation purposes. The scores for both tests are recorded on the Test Score Tracking Sheet and used to determine which CMEs will be needed in the future. Scores will also be recorded on the Training Report. 3. Distribute the Pre-Tests the DTs completed on Day One of TOT. 4. Ask each DT to score their tests, using the Pre-Test Answer Key in their Trainer Guide on page 98. TOT Guide Page 23

24 5. Ask DTs to find the Sample Test Score Tracking Sheet on page 109 in the Trainer Guide. Explain how to complete. 6. Explain how the Test Score Tracking Sheet will be used to determine gap areas for Training and future CMEs. Each question is worth 4 points. 25 correct answers = 100% Divide the total number of correct answers by 25 to determine the % score. E.g., 23/25 = 92% Determining the Knowledge Gap by Topic Area: Topic Range of Questions Number of incorrect answers = Gap Interpersonal Communication 1 through 7 3 or more Assessment of fever 8 through 12 2 or more Diagnosis of malaria 13 through 20 3 or more Differential Diagnosis of fever 21 through 25 2 or more 7. Discuss how to plan for CMEs. Evaluation Summary Sheet 1. Ask the DTs to find Handout 5A Health Provider Training Evaluation Form on page 95 of the Trainer Guide and the Evaluation Summary Template on page 109 of the TG. 2. Explain that the Health Provider Training Evaluation Form is completed anonymoulsy. 3. Explain that the first set of evaluation questions correspond to the learning objectoves and are intended to measure the health providers perception of how they will be able to apply what they learned in the health facility. 4. Explaing that before completing the Training Report, the DistrictTrainers will need to tabulate the evaluation responses on the Evaluation Summary Template. 5. Explain how to complete the Evaluation Summary Template: Complete the top portion. Count the total number of health providers who completed the form. Count the total number of responses for 5; 4; 3; 2; or 1 for the first set of evaluation questions (1-14). Enter the totals on the Summary Template Calculate the percentage by dividing the number of responses for each response (5, 4, 3, 2, 1) by the total number of participants. Summarize and write the health providers responses to the second set of evalution questions (15-21). TOT Guide Page 24

25 Completing Training Reports 1. A Training Report must be completed at the end of each health provider training and submitted to SMP. 2. Ask DTs what is the purpose of a training report. Used to communicate information to stakeholders such as the NMCP and funding organizations Provides information about how the trainings were delivered, how they were received, their impact, and any additional observations and recommendations. Used to help analyse whether the training objectives were met, lessons learned and recommendations. 3. Ask DTs to find the Training Report Template on page 113 of the Trainer Guide. 4. Ask what information is needed to complete the Training Report and where the information can be obtained: Participant demographics Attendance Register and observation Objectives met Final Evaluation Forms and summary template Knowledge gained Pre-and Post-test scores Skills learned Competency checklist and trainer s observations Recommendations for CME topics Post-Test scores, Competency Checklist and trainer s observations 5. Explain that the following documents need to be included with the Training Report when it is submitted to SMP. The original Attendance Register is submitted to the SMC Project Office with the Training Report. The copy of the Attendance Register is submitted to health facility/district health office. Test Scoring Sheet and all the Pre- and Post-Test for M&E verification. Evaluation Summary List of health providers who completed the 2-day training and received certificates. Supervision Checklist 1. Remind the DTs about the IPC Core Competencies that were used during the training roles plays in the health provider trainings 2. Explain that those same competencies will be used to assess health providers performance in the health facilities during the 3 monthly support supervision visits after the trainings. TOT Guide Page 25

26 3. Explain that the DTs will be conducting the first supervision visit along with the Master Trainers and then the District Trainers will conduct the other 2 visits on their own. 4. Give the DTs a copy of the Health Facility Supervision Checklist. 5. Ask the DTs to review the Supervision Checklist, and ask them what they think the purpose of the checklist is. To ensure the health providers have the tools to apply what they learned in training. To assess health provider knowledge and skills learned inn training are being applied in the work place. To provide additional mentoring where gaps in skills exist. To provide praise and positive feedback for goof performance. To provide constructive feedback 6. Explain and review the 3 parts to the checklist: A. Health Facility Assessment B. Health Provider Assessment C. Health Provider Performance Appraisal Summary Sheet 7. Explain how the DTs will complete the Performance Appraisal Summary Sheet for each health provider and how they will use to track their performance over time. TOT Guide Page 26

27 Session Eight Close of TOT Time: 30 min Materials: TOT Evaluation TOT Certificates (completed and signed) TOT Evaluation 1. Ask the DTs to complete the final TOT Evaluation Form in their handouts. 2. Collect the TOT Evaluation Forms. TOT Certificates 1. Say a few brief words about: The importance of health providers applying IPC skills with patients and caregivers in the health facilities. The importance of Test before Treating fever and compliance with test results. What the DTs have accomplished during the TOT. 2. Congratulate the DTs for their hard work and achievement. 3. Call out each DTs name one-by-one and award the Certificates of Completion 4. End the TOT and thank the DTs for their participation. TOT Guide Page 27