Transcript The National Tuberculosis Surveillance System Training Program to Ensure Accuracy of Tuberculosis Data 2010 USPHS Public Health Conference Lilia Manangan, Elvin Magee, Cheryl Tryon Division.

The National Tuberculosis Surveillance
System Training Program to Ensure
Accuracy of Tuberculosis Data
2010 USPHS Public Health Conference
Lilia Manangan, Elvin Magee, Cheryl Tryon
Division of Tuberculosis Elimination
Centers for Disease Control and Prevention (CDC)
1
Presentation Overview
• National Tuberculosis Surveillance System
Training Program
• Process for Developing, Implementing, and
Evaluating the Training Program
• Systematic Approach to Health Education
• Lessons Learned
• Next Steps
National Tuberculosis
Surveillance System
• Report of Verified Case of TB (RVCT) standardized data collection form for
TB disease surveillance
• Web-based reporting
• Data used to create annual TB
surveillance report, monitor TB trends,
and program planning
Revised Report of Verified Case of
Tuberculosis (RVCT)
RVCT
Page 1 (Items 1 – 16)
Initial Drug
Susceptibility Report
(Follow-Up Report – 1)
(Items 38 – 40)
Page 2 (Items 17 – 25)
Page 3 (Items 26 – 37)
Case Completion Report
(Follow-Up Report - 2)
(Items 41 – 49)
4
RVCT Revision Timeline
1993
2001
2005
2007
Requested
comments
from TB
partners
2008
2009
RVCT
implemented
5
RVCT Training Program
• Purpose
– Train health care workers to accurately complete
the revised RVCT
• Target audience
Health care workers from state and local health
departments, territories, and Pacific Islands who
• Collect data from patients
• Complete RVCT form
• Enter data from RVCT into data system
• Monitor accuracy of TB program data
collection
• Analyze data from RVCT
6
Create a Training Plan
• Provide a detailed description of the project
• Share with team members
• Revise throughout project
Training Plan
•
•
•
•
•
•
Background
Goal of the Project
Target Audience
Objectives
Project Description
Related Projects
(if appropriate)
• Authorization
• Primary Team Members
(roles and responsibilities)
• Additional Team
Members (reviewers,
partners and stakeholders)
• Development Schedule
• Training Schedule
• Travel Needs
• Budget
• Evaluation Plan
• Clearance (if necessary)
7
Systematic Approach to
Health Education
1
Conduct Needs
Assessment
4
Develop &
Pretest
Concepts,
Messages,
& Materials
2
Assess
Effectiveness
& Make
Refinements
Implement
the Program
3
8
Why Use the Systematic Process?
Following
these
essential
steps
leads to
Effective and successful
health education
materials and trainings
9
Goal of Any Training Program
Increase
knowledge
Improve
skills
Improve
attitudes
Change behavior so that
performance will improve
Our goal: To increase accuracy
of TB surveillance data
10
Systematic Approach to
Health Education
Conduct Needs
Assessment
4
1
Develop &
Pretest
Concepts,
Messages,
& Materials
2
Assess
Effectiveness
& Make
Refinements
3
Implement
the Program
11
Conduct a Needs Assessment
A needs assessment is a
systematic process for
obtaining and analyzing
information to determine
the gaps between
The way things
“are”
The way things
“ought to be”
12
Needs Assessment
• Identified target audience(s) characteristics
– Job positions
– Knowledge level about the content
– Skill level needed to perform the tasks
• Determined what was needed to perform the
job
– Content (e.g., information, facts, statistics)
– Tasks (skills such as complete registers/forms,
analyze data)
– Resources (e.g., materials, supplies, equipment,
space)
13
Information Gathering
•
•
•
•
Reviewed surveillance data
Conducted expert reviews
Conducted focus groups
Reviewed surveillance
training methods
• Determined budget
• Developed justification for
training
14
Systematic Approach to
Health Education
Conduct Needs
Assessment
4
1
Develop &
Pretest
Concepts,
Messages,
& Materials
2
Assess
Effectiveness
& Make
Refinements
Implement
the Program
3
15
Process for Developing Materials
•
•
•
•
•
•
•
•
Chose Project Team
Selected Type(s) of Training
Selected Training Methods
Selected Media
Determined Resources
Developed Content
Designed and Produced Materials
Pretested Materials
16
Selection of Types of RVCT
Trainings and Training Activities
• Based on adult learning principles
• Best methods for gaining the skills
• Needed flexible types of trainings to
meet various situations
17
3 Basic Learning Styles
Visual
Auditory
Tactile
Learn through
Learn through
Learn through
• Watching
• Listening
• Moving
• Observing
• Speaking
• Doing
• Reading
• Practicing
• Touching
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What Adults Remember
Read
More
participation
equals
more
remembered
Hear
See
Hear & See
Say
Say & Do
% of What Adults Remember
For people to learn something,
they sometimes have to hear it 7 times.
19
Types of RVCT Training
RVCT Self-Study Modules
Participants worked at their own
pace using the print-based modules
Training activities
• Read instructions on how to
complete each item
• Worked through study questions
and case studies
20
Types of RVCT Training (cont.)
Facilitated Training Sessions
Facilitators led training sessions
• Conducted with large and small
groups
• Introduced the content and led
discussions
(not a lecture-based training)
Training activities
• Worked through the Self-Study
Modules
• Discussed content, study
questions, and case studies
21
Types of Training Activities (cont.)
Training-of-Trainers
Teachback Methodology was
used to teach participants how
to teach the facilitated training
session to others
Training activities
• Facilitators used interactive lectures
and exercises on training basics
• Participants
• Observed training demonstrations
• Practiced teaching the course
• Received feedback
22
Conducted 5 Curriculum Pretests
with Target Audience
• Analyzed results
This is important
– Reviewed comments from participants
• Remained objective and open to suggestions
• Incorporated appropriate ideas
– Conducted item analysis on all questions
• Determined how each question was answered
(by entire group and specific individuals)
• Determined which items had problems and
what was causing the problems
• Revised materials as necessary
23
Course Manuals
RVCT
Self-Study Modules
Participant
Manual
RVCT
Self-Study Modules
Facilitator
Manual
24
Materials on CD ROM
or download from FTP site
ftp://ftp.cdc.gov/pub/Software/TIMS/2009 RVCT
Documentation/RVCT Training Materials/
• RVCT Self-Study Modules – Participant Manual
• RVCT Self-Study Modules – Facilitator Manual and
other training materials
• RVCT Instruction Manual (instructions only)
• RVCT Self-Study Modules Exercises (exercises only)
• RVCT Materials Description
25
Systematic Approach to
Health Education
Conduct Needs
Assessment
4
1
Develop &
Pretest
Concepts,
Messages,
& Materials
2
Assess
Effectiveness
& Make
Refinements
Implement
the Program
3
26
Implementation
• Collaborated with health departments
• Trained volunteer trainers
• Developed a distribution and marketing plan
for the materials
– Reviewed a sample production copy before mass
copies were duplicated
• Logistics
– Determined number of trainings and course
materials needed
– Monitored travel and budget
27
States/Jurisdictions that Have
Received RVCT Training
D.C.
• American Samoa
• Federated States of
Micronesia
• Guam
• Northern Mariana Islands
• Palau
• Puerto Rico
• Republic of Marshall
Islands
• Virgin Islands
Received training
No training
28
Number of Health Care Workers
Trained on the RVCT as of 9/30/2009
Training Type
Training Type
Training-ofTrainers
# Trained
5 Field Tests
11 Trainings
64
233
Total Trained
297
# Trainers
Trained
82
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Systematic Approach to
Health Education
Conduct Needs
Assessment
4
1
Develop &
Pretest
Concepts,
Messages,
& Materials
2
Assess
Effectiveness
& Make
Refinements
Implement
the Program
3
30
Types of Evaluations
Type
When is it
conducted
What is measured
Formative During
pretests
• Reactions
• Learning and performance
Process
During
implementation
Outcome
After
implementation
•
•
•
•
•
Impact
After
implementation
Procedures
Tasks
What is working
Immediate or short-term effects
Learning and performance
• Long-range results of the training
program
• impact on job performance and
change in program indicators
31
Participant Comments about the
RVCT Training Courses
• I learned a lot. Very informative.
I will now be able to apply the
newest revisions to the RVCT.
• It gives me complete information
on how to fill out the RVCT form
accurately and concise
information to report on all TB
cases in geographic, treatments, adverse effects on
any medications, and the drug susceptibility and
completion of therapy.
32
Participant Comments about the
RVCT Training Courses (cont.)
• The course was good because
it has interactive sessions and
all participants had input and
comments. It is very good to
see the revised/new variables.
• The Instructors are motivating
as trainers and ask questions if
we need to clarify all that is discussed.
• There were some items that I thought I was filling in
correctly, but now I know that I need to change some
things.
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Lessons Learned
• Input from the field staff (reviews, field tests,
trainings)
– Enhanced our training materials
– Motivated people to collect more accurate data
• Established strong and valuable
relationships with field staff
– Communication opened-up with groups that have
been distant in the past
– Encouraged more collaboration and questions to
submit accurate data
Lessons Learned (cont.)
• Use of case studies help apply content
– Participants said it was “fun”
• Use of visuals (e.g., tables, diagrams) to
make content easy to grasp and refer to
• Designed manual to be
– User -friendly, easy to locate things for reference
– Flexible for use in various types of trainings (selfstudy, facilitator-led training sessions)
Lessons Learned (cont.)
• Best as facilitator-led training with
discussions
• Not appropriate for computer-based course
• Not appropriate for webinar (good for update
or reviewing a small number of items)
Next Steps
37
Thank
you
38