Getting Real: Lessons from the Field
15th Annual Neonatal Advanced Practice Nursing Forum:
Show Me the Evidence
June 2, 2012
Linda L. Wright, MD
Deputy Director, CRMC, NICHD, NIH
Director, Global Network for Women’s & Children’s
Health Research
Goal of “Get Real”
Tricks of the trade for your HBB training (views
are 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 highlevel 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 Research
http://gn.rti.org
Linda L. Wright, M.D.
Wrightl@mail.nih.gov
301-402-0830 (O)
301-480-7773 (F)
Action
Plan
Laerdal Prototype for HBB