Development of Curriculum based on professional competencies. Prof. Dr. Gustavo E. Zabert Jennifer S. Packard, MA, CTTS, CWC

Transcription

1 Development of Curriculum based on professional competencies Prof. Dr. Gustavo E. Zabert Jennifer S. Packard, MA, CTTS, CWC 1

2 NDC Education Program Supporting a Competent Workforce Program Accreditation Organization Performance Workforce Competencies Individual Credentialing Individual Performance Workforce Competencies Instructional Competencies Curriculum Process Miner, 2004, Step up to Tobacco Control 2

3 Tobacco Treatment Specialist Training ATTUD Core professional competencies 2005 Mayo program - curriculum based on competencies CTTTP Accreditation of training programs 2010 Mayo program closely reviewed based on accreditation standards 3

4 Wellness Coach Training Program Mayo Curriculum developed Best practices from multiple disciplines Many programs offering certification Academia, private enterprise NCCHWC Job task analysis (JTA) Move toward national certification Mayo Program accreditation Curriculum adjusted based on JTA 4

5 LA Global Bridges Aim 1: to develop a large network of health care providers and organizations Aim 2: to survey the smoking cessation training programs in Latin America as well as the organization that provide support and/or endorse the curricula Aim3: To develop a training strategy for HCP and train at least 150 HCP in a basic level and 20 HCP in an advance level to act as faculty 5

6 LA Global Bridges Aim 1: to develop a large network of health care providers and organizations 2049 Health Care Providers contacted in LA. 78 NGO and Governmental offices contacted Large network interaction 6

7 LA Global Bridges 2011 Aim 2: to survey the smoking cessation training programs in Latin America as well as the organization that provide support and/or endorse the curricula Leaders as well as faculties were identified. Curriculum of five training courses in LA were found (ALAT, SEPAR, IAHF, CiTTa, AsAT) Each curriculum were reviewed and appraised with ATTUD standards. A core curriculum for a SC basic course was agreed with ALAT, SEPAR and IAHF s tobacco leaders Evaluation form was designed ( Declarative Knowlwdge) 7

8 LA Global Bridges May 2011 Aim: To develop a training strategy for HCP and train at least 150 HCP in a basic level and 20 HCP in an advance level to act as faculty ( see one, do one and teach one ) 1614 HCP were trained 50 Faculties from 10 countries 8

9 Rational to develop training instrument ATTUD standards 11 core competencies Skill set (knowledge and practices) Level of mastery A-K-P Develop Slide set Slide message refered to each skill Supported by reference 9

10 Example of arquitecture in knowledges Slide Notes Message ATTUD competency REF La mortalidad anual atribuible al tabaco en México estimada por la CONADIC, alcanza a Evaluation pre and post 10

11 Example of arquitecture in Practices «Case problem» Slide Questions to be answered Individual evaluation was NOT considered 11

12 Themes for 2012 Define a Global Core Curriculum Broaden Reach within each Region Communicate accomplishments and opportunities Identify and pursue additional Funding 12

13 LA Global Bridges Moore level 3a 100% 75% Pre Pos 88.9% 84.5% 85.8% 78.9% 79.0% 73.7% 74.5% 94.2% 87.2% 82.8% 78.2% 84.5% 86.8% 79.8% 78.3% 79.9% 75.0% 87.9% 80.0% 75.8% 50% 64.7% 49.0% 39.5% 34.9% 62.2% 58.9% 55.8% 54.6% 41.5% 42.7% 57.7% 55.4% 50.0% 64.3% 48.6% 62.2% 64.3% 51.7% 54.2% 28.6% 28.1% 27.1% 25% 0% p1 p2 p3 p4 p5 p6 p7 p8 p9 p10 p11 p12 p13 p14 p15 p16 p17 p18 p19 p20 Total N=

14 Global Core Curriculum - Benefits Evidence-based Comparability across regions Facilitates program evaluation Allows for progression of learning ( bronze, silver, gold ) Ownable Ultimately, can charge for training 14

15 Pre- and Post-Tests: 3 Regions PRE TEST Africa Eastern Mediterranean Latin America + Caribbean #Questions 8 (7+1) POST TEST #Questions 9 (7+2) 24 + case 20 FORMAT MC + OE MC + OE MC WHAT IS BEING ASSESSED? Mastery of Content Yes Yes Yes Learner Satisfaction Yes Yes Learner Confidence with MI Yes Other Interest in e- learning 15

16 Minimal Dataset All regions include questions on: Tobacco use prevalence (local or global) Stages of Change Exhaled CO as biomarker Types of intervention: administration, duration, success rates, side effects, supporting data Two regions ask questions on: FCTC, Benefits of quitting, mechanism of addiction, Fagerstrom test, motivational interviewing One region asks about: role of HCP, effect of exposure to SHS, tobacco products 16

17 LA Global Bridges Moore level 3a-b and 4 pos pre Confidence in competence Level % 93.50% 10,0% P < 0,001 N=443 Procedural Knowledge Level 3 b N= % 80.90% 14,1% P < 0,05 Declarative knowledge Level 3 a 54.20% 75.80% 39,9% P < 0,001 N=

18 Moore's 7 Levels of CME Outcomes Measurements 18

19 LA Global Bridges Capacity building for smoking cessation training in Latin America: expanding the work of Global Bridges Project Objectives: 1. Develop a smoking cessation Train-the-Trainers (TtT) curriculum adapted to the LA region and consistent with the WHO s Building Capacity for Tobacco Control 2. Provide face-to-face TtT courses and develop a GBLA smoking cessation Trainer s team in partner organizations. 3. Provide smoking cessation training (SCT) sessions in partnership with healthcare organizations. 19

20 LA Global Bridges Capacity building for smoking cessation training in Latin America: expanding the work of Global Bridges Material: 1. WHO training package Strengthening health systems for treating tobacco dependence in primary care (PAHO s translation to Spanish) a. Part III: Training for primary care providers: brief tobacco interventions; b. Part IV: Training for future trainers: applying adult education skills to training. 2. GLOBAL BRIDGES evaluation form 20

21 LA Global Bridges Capacity building for smoking cessation training in Latin America: expanding the work of Global Bridges Strategy: 1. The intervention strategy was to approach organizations to partner with the GB&IAHF to build capacity for smoking cessation training within their organizations 2. GB&IAHF offered a two day training session (Day 1 - Train the Trainer module and Day 2 - Smoking Cessation program) 3. TT module was lead by our team expert in medical education. 4. Partner organizations were requested to sign a letter of agreement with IAHF for the project, to select and propose SC experts to attend TT module, and schedule at least 2 SC sessions in the following year. 21

22 LA Global Bridges Capacity building for smoking cessation training in Latin America: expanding the work of Global Bridges Outcomes: 1. TtT: competent trainers to provide training for treating tobacco dependence in primary care setting. 2. SC training: competent healthcare providers that routinely deliver brief interventions to help tobacco users quit and protect from exposure to second hand smoke. 3. Training sessions provided by partner organizations 22

23 LA Global Bridges Capacity building for smoking cessation training in Latin America: expanding the work of Global Bridges Barriers: 1. Timetable of partner organizations 2. TT attendees were chosen by partner organizations and competencies and TC mastery were irregular among them Solutions 1. Partner organizations were requested to sign a letter of agreement with IAHF for the project, to select and propose SC experts to attend TT module, and schedule at least 2 SC sessions in the following year. 2. Attendees Key selection criteria (KSC), acreditation an certification and expert s support. 23

24 LA Global Bridges Key selection criteria (KSC) for HCP that apply for TTT background knowledge smoking cessation experience communication skills teaching abilities emotional stability 2. Accreditation and certification criteria for Trainers Attendees: attendees that satisfy KSC but do not satisfy components of competence or performance. This category may act as facilitator in case presentation or role playing but do no accredit as assistant trainer or trainer Assistant Trainer: do not satisfy one component (competence or performance).this category may act as facilitator in case presentation or role playing or lecturer but do no accredit as trainer Trainer: fulfill competence and performance. This category endorse to lecture and to chair a SCT session and to be included to TTT team 3. Expert s follow up and backup of Trainers team (Esteban Cruz Gamma) Facebook (Programa Entrenadores GBLA FIC) Toolbook for TtT, Portfolio, peer evaluation and tutor support Online upgrade TtT (under development in Blackboard platform) Qualitative evaluation 24

25 Some Photos 25

26 Pompous Zabert Doctrine s 2013: Real world impact estimation What would be the pop s impact of SC training? Scenario estimations if each HCP trained by GB offers ONE (1) brief advice (BA) every working day in the year after training? 1384 HCP trained till 2014 X 240 working days = 332,160 smokers 332,160 BA X 2,5% (abstinence rate) = 8,304 BA s quitters if 20% of remaining smokers receive NRT plus intensive intervention (IT) in the following year? (332,180 smokers 8,304 BA s quitters) * 20% = 64,771 smokers IT+NRT 64,771 smokers IT+NRT X 12% (abstinence rate)= 7,771 IT+NRT s quitters 16,076 quitters per year after training 26

27 LA Global Bridges trainees survey Survey among all GB trainees (all that attended at least to one session) Web based (Survey monkey) 26 questions: Demographics, Confidence in skills and SC practices trainees with valid s, sample size 400 in 3 waves for recruitment but it was achieved in 2 (n=402). Response rate ( % and %) Smokers assisted per day Smokers assisted per year Brief advice (680%) Quitters BA Intensive Conseling (69%) Quitters IC Total Quitters Lower CI 1,6 Mean 2,1 Higher CI 2, Data Source HCP Trained by GB Database Brief Advice 80% 2016 Survey Intensive counseling 69% 2016 Survey Quit rate BA 2,50% Cochrane Quit rate IC 12% Cochrane 27

28 LA Global Bridges trainees survey 2016: Real world impact estimation What would be the pop s impact of SC training? Survey worst scenario 80% of GB trainnees referred to offer 1,6 brief advice (BA) every working day in the year after training? trainees X 80% X 240 working days X 1,6 = smokers BA X 2,5% (abstinence rate) = BA s quitters 69% GB trainnees referred to offer NRT plus intensive intervention (IT) in the following year? ( BA s quitters)x69% = smokers IT+NRT smokers IT+NRT X 12% (abstinence rate)= IT+NRT s quitters quitters per year after training 28

29 Some thoughts 29

30 References Miner K. A competency discussion for tobacco prevention and control. In: ASPH/American Legacy Conference Step up to Tobacco Control:; 2004, St. Louis, MO,