Facilitator training

The course was preceded by a three day facilitator training (12-14 February 2009). The course coordinator, who is the ICATT national consultant responsible for the national adaptation and translation of ICATT and who participated in facilitating the first ICATT course in Tanzania, trained six facilitators (including clinical instructors). Among the facilitators, there were 2 district facilitators from the council hospital and 4 KLCOTC tutors.

The teaching of the first training units was first demonstrated by the course coordinator, and then a facilitator trainee was asked to teach the same unit. The teaching of the remaining units was distributed among the facilitators. Feedback on the principles of facilitation, correctness of explanation of the IMCI technical content s and ICATT navigation was provided after each unit. A special attention was paid to the recent technical updates in IMCI guidelines - the facilitator trainees worked through the relevant ICATT sections including exercises and checked their answers to the TEST exercises in the ICATT Check results sheet. The draft Facilitator aid for LCD projected teaching was used for the facilitator training. Facilitating clinical sessions and role plays was also practiced.

Training course

Thirty nine students were trained in the course. Three experienced facilitators taught ICATT (facilitator : student ratio 1:13) and conducted together with four additional tutors the clinical practice sessions (facilitator : student ratio 1:5-6). Of the total 65 course working hours, 37 (57%) were devoted to work with ICATT, 21.5 hours (33%) to clinical practice sessions; remaining 10% of time was devoted to opening and closing sessions and activities complementing the ICATT training (e.g. reviews, role plays, drills, post- test). Two drills and two role plays were conducted.

ICATT sections READ, SEE, and PRACTICE were worked through in the classroom sessions. Before the training, it has been decided to omit several exercises from the ICATT PRACTICE part due to the time constraints (Suggestions for an abridged version are available from the ICATT support website Administrator). The TEST exercises were printed and students completed them as homework. The facilitators, including the clinical instructors, marked the TEST exercises. The mean proportion of correct answers was 84%.

The Tanzania IMCI national adaptation includes HIV&AIDS in both, the young infant and older child, and assessment for gestational age a low birth weight. These added items accounted approximately for 2.5 hour ICATT work.

In the post-test, the mean proportion of correct answers with a credit for partially correct answers was 89.6%; 36 of 39 students achieved ≥80% correct answers with a credit for partially correct answers.

All participants said that for future training they would prefer computer courses similar to ICATT to the usual way of training.

Important observations:

• Each facilitator needs to have his or her own computer with ICATT loaded during the facilitator training and during the course.
• For the best quality of the projected image, adjust the computer desktop resolution to the native LCD projector resolution (usually 1024 x 768 pixels). If you cannot do that, try which of the computers available gives the best projection result.