4:22
Again, the issue of attainability implies that a particular
objective is inextricably, interwoven with the overall planning process.
We need to make sure that we have the resources needed
to allow the trainee to acquire those skills within the time available.
In order for an objective to be realistic, it must be based on the expected outcomes.
The knowledge, skills, attitudes that are relevant and
appropriate for the job description.
Are we training a village health worker to do what is appropriate for them, such as
providing a village drug box and counting out appropriate tablets for Malaria?
And inappropriate, or unrealistic skill would be
to teach them how to give injections, which they demand, but is inappropriate.
It's not realistic, it's not safe, in a community situation.
6:23
The issue of what is realistic or
appropriate to the kind of work contribution that each of these sets of
people would make toward the program need to be considered.
The village volunteers or the peer educators may be good at the counseling.
The peer educators might appropriately distribute condoms.
But when it comes to more medical or technical things,
when it comes to identifying and treating people who have STDs.
These may need to be referred to the community nurses, the physicians.
The laboratory staff would have a role.
So each of the different groups involved in a community health
program have a different job description, have different contributions to make.
And so objectives for the training of each of these groups would differ based on
the what is realistic in terms of their job performance and expectations.
10:35
Okay, dosages of what?
It's not specific.
Is it measurable?
Well how do we measure appreciation?
We can't, again, get inside the person's head and
see if maybe there's someway we can do a CT scan and if they appreciate,
it will give off certain electrical charges are not but right now,
we don't have those kinds of tools to measure knowledge and appreciation.
Attainable, well, it's hard to say since it's not specific whether this is
something that we can do within the context of the training, possibly.
Is it realistic?
Well the idea of knowing knowledge of doses is important, something
we could achieve, but the way the objective is framed it makes difficult and
there is no time factor implied in or written into the objective.
Is this something that will happen two years from now,
is it something that'll happen within a one hour training session.
The third objective is a little better than the second.
Patent medicine vendors will count out the correct number of chloroquine tablets for
a 12 year old child.
More specificity about the behavior, the kind of medicine,
the age of the child, the behavior of counting.
We can measure that the person counts the correct number.
We have that information and we can watch and see if they
count out how many tablets, whether they divide in half or in quarters.
It's certainly attainable, it's something that they would do on the job,
it's part of their job description,
it's something we could do within the resources that we have.
Realistic?
This is a question that gets back to the legal aspects of medicine vending.
Yes, in most cases they buy drugs in bulk because it's cheaper,
and cheaper for their clients too, for their customers.
But it's not exactly legal for them to count tablets, so
we have to think twice about that.
And again, there's no time factor mentioned in this objective.
13:18
Clearly, the first one starts off with a problem,
in the sense that it doesn't have an action verb, so we can't measure it.
We can observe in practice sessions and
in follow up visits the PMVs explaining the correct dosage and
procedures for administering tablets to the child.
So this is more specific although it's not time bound.
The third one, tell parents how to take the drug.
This one is quite vague.
It at least starts off with a verb that we could observe, but we don't
really know what we're going to observe, what is the correct action or not.
And as we said, our objective should be a roadmap to let us know,
as well as the trainee know, what it is that he or
she is going to do as a result of having been trained.
14:11
Now we're heading toward putting together a training guide.
Each of you, during the course, will be thinking about, recruiting trainees,
and developing a program for them.
And now that we have talked about formulating objectives,
what we want to do is turn these objectives into training plans.
An easy shorthand to help you get your plans organized is
seen in the matrix here for the objective
of the primary worker will provide prompt treatment for a child with malaria.
This training matrix puts together the content,
the simple steps, your tasks that are involved,
the methods that will be used to teach, and instruct, and learn.
The resources that it'll take to carry out those methods.
And ideas for how to evaluate whether the objective and the specific
tasks have been achieved, whether the skills have been acquired by the trainees.
So we will be using in our labs these types of matrices, and
building them up week by week.
You will start off, of course, having had set an objective.
And break that down as we talked about in our earlier lectures into the steps that
are necessary to perform that particular skill.
In terms of providing prompt treatment, we want to be sure that
the first step is an understanding of the need for prompt treatment
to prevent children from dying from malaria, and we again use verbs.
The trainee will explain why the treatment is necessary and why malaria is dangerous.
We can listen to that.
Again, we want to make sure that appropriate treatment is given and
the trainee will feel the child to determine if the temperature is elevated.
We don't want the trainee, the patent medicine vendor,
to make these decisions all alone.
The customer should be involved,
especially if we're talking about parent of a young child, so
the trainee will ask the mother about the history of the child's illness.
And based on the information gathered
determining if the child actually needs malaria medicine,
count out the correct number of tablets for the child according to its age.
So for each of these steps, we want to see what kind of methods are appropriate.
In our subsequent lectures we will talk about methods.
We will talk about resources and we will talk about evaluation.
But as we can see, these matrices will help us pull up all of our thoughts
together and we'll be submitting them as we go along, and
getting feedback, and continuing to fill in, step by step, week by week.
Ultimately, this will be used as the basis for
developing a full-blown training guide.
But these are some examples to get us started to see now that we've
developed some objectives.
And we've started talking about what the content is that's implied in those where
we are going.
A second example the matrix continues and we can see that there are more steps.
The fifth step would be to explain to the mother how the medicine should be given.
Encourage the mother to give the child extra fluids.
Record the treatment in a notebook.
Review the child's condition by the third day.
So for each of these we've talked about whether we're using role playing,
brain storming,
demonstrations, the kind of resources we need in terms of a flip chart.
Of course, you could use PowerPoint if you are in the city and
have electricity and a computer.
We want to make sure that we consider who are the trainers,
whether we need guest speakers to provide information.
We may need to provide handouts that write out scenarios for the role play.
We probably need samples of the different drugs for them to practice with.
Notebooks, pencils, those kinds of things that are necessary to record treatment.
We're estimating relative cost in local currency, for example,
to get an idea of building up a budget as we go along, that's an important resource,
the time that it will take to do each of these tasks is spelled out.
So these are all part of our resources and
they appear on these charts to help us plan more effectively.
18:31
Finally, the evaluation aspects of it,
there are some things we can do immediately.
As we go along or at the end of the session we can ask questions,
we can ask trainees to do what we call return demonstration or
repeat the demonstration for us and other trainees to observe and get feedback.
We can observe their role play,
various activities to see if they are gaining the skills.
Listen to what they're saying in terms of picking up on their attitudes
about the new skills.
And of course, as ultimately we get to the end of the training,
there may be tests that pull all of this together.
So as I mentioned before, we will be working on all of these steps,
all of these components with training plan through developing these matrices