Getting Real: Lessons from the Field

15th Annual Neonatal Advanced Practice Nursing Forum:

Show Me the EvidenceJune 2, 2012

Linda L. Wright, MDDeputy Director, CRMC, NICHD, NIHDirector, Global Network for Women’s & Children’s Health Research

Goal of “Get Real”

Tricks of the trade for your HBB

training (viewsare strictly my own):

• The agenda

• Starting “right”

• Using adult learning model as

trainers

• The Global Network training

model

• Ending well

The agenda

• Choose trainers early (train as teams with gender/training balance; key leader)• Spend time tweaking agenda• Rehearse at least the night before• Work out a detailed schedule with roles; procedures for registration, testing; data collection • Define pass criteria, allowed tries• Consider providing overview, registration before meeting to save time/confusion

The agenda

• Choose trainers early (train as teams with gender/training balance; key leader)• Spend time tweaking agenda• Rehearse at least the night before• Work out a detailed schedule with roles; procedures for registration, testing; data collection • Define pass criteria, allowed tries• Consider providing overview, registration before meeting to save time/confusion

Starting “right”• Big room with good lighting, temperature

control, lots of mikes, <25 trainees• Large rectangular tables (6/1) with same

demonstration table in the front• Set up the night before; minimize clutter

• Provide Action Plan on easel,1 pillow, 1

bag/mask, 1 flip chart, 1 NeoNatalie, 1 clean delivery kit, 1 timer, 6 workbooks initially at each table (all else below)• Begin day with breakfast in room

Starting “right”• Big room with good lighting, temperature

control, lots of mikes, <25 trainees• Large rectangular tables (6/1) with same

demonstration table in the front• Set up the night before; minimize clutter

• Provide Action Plan on easel,1 pillow, 1

bag/mask, 1 flip chart, 1 NeoNatalie, 1 clean delivery kit, 1 timer, 6 workbooks initially at each table (all else below)• Begin day with breakfast in room

Starting “right” - 2

• Start on time • Observe opening re local customs (dignitary to open with prayer, ceremony) • Follow with introductions with name, role,

training experience, context• Consider seating folks as facility teams

• Switch trainers if needed use a different

“test” than “teaching” trainer• Encourage practicing by keeping room

open early, late, over breaks

Adult learning training model• Inherently anxiety-provoking• Start with a visioning process to focus

and engage them in the mission• Demonstrate in front, then at the tables,

then as dyads for each major session• Consistently model what you want the

learners to do: teach by demonstration• Ask them to hold breath 1” at some point

Adult learning training model• Inherently anxiety-provoking• Start with a visioning process to focus

and engage them in the mission• Demonstrate in front, then at the tables,

then as dyads for each major session• Consistently model what you want the

learners to do: teach by demonstration• Ask them to hold breath 1” at some point

Adult learning training model• Inherently anxiety-provoking• Start with a visioning process to focus

and engage them in the mission• Demonstrate in front, then at the tables,

then as dyads for each major session• Consistently model what you want the

learners to do: teach by demonstration• Ask them to hold breath 1” at some point

Adult learning training model - 2• Demonstrate; then ask them to demo;

self reflection before feedback• Use flip charts and Action Plan• Encourage questions, stories, practice• Pose problems and help to problem

solve – engagement is critical• Review each section and foreshadow

the next• Include an observer; debrief daily

Global Network Training Model

• MasterTrainer/Facilitator at each facility• Maximal hands-on resuscitation skills• Pool of Master Trainers large as possible

to train all birth attendants rapidly • Minimize cascade for consistent high-

level training for all providers (minimize dilution) and reduce costs

Ending well:

• Additional practice if not yet “testable”• Minimize testing stress

• Do a demonstration on filling/emptying• End with a final review session on:

• What we’re going to do• What we’re going to change

• Award signed certificates of training and

pins if possible• Take lots of pictures

Ending well:

• Additional practice if not yet “testable”• Minimize testing stress

• Do a demonstration on filling/emptying• End with a final review session on:

• What we’re going to do• What we’re going to change

• Award signed certificates of training and

pins if possible• Take lots of pictures

Final word: To ensure sustainability

• Get buy in from government, professional groups, birth attendants (BAs), mothers

and their mothers before you train• Develop a master plan to ensure proper

coordination and quality improvement• Train as many BAs as possible from the

outset for momentum/publicity• Work on improved accountability and

ownership

THANKS!

Global Network for Women’s and Children’s Health Researchhttp://gn.rti.org

Linda L. Wright, M.D.Wrightl@mail.nih.gov301-402-0830 (O)301-480-7773 (F)

Action Plan

Laerdal Prototype for HBB