Page 101 - GHES-2-4

Global Health Economics and
Sustainability
Sustainable, competent health trainers

Table 2. Methodical six‑step approach to building master trainers (MT) cadre and lessons learned
Serial number Name of the step Details Lessons
Step 1 Pre-ToT screening of identified (i) Teaching skills, work profile, and previous (i) Helped in optimal utilization of
candidates (n=48) experience as a trainer resources for conducting the ToT with
(ii) Expected commitment to the project selected candidates
(iii) Scoring above the threshold and willingness
as potential trainers
Step 2 Training of potential trainers (i) Imparting clinical knowledge, skills, teaching (i) Led to objective assessment of
(n=32) with pre- and post-ToT skills using adult learner principles, and trainers and identification of gaps for
assessment simulation-based learning improvement
(ii) Written examination, structured
observation of clinical demonstration, and
teaching skills with check-list
(iii) Composite score of post-ToT assessment:
18 MTs with highest scores and 14 MTs
with intermediate scores
Step 3 Staggered induction of selected (i) Master trainers with intermediate scores (ii) Provided more time and support to
candidates as trainers paired up with the highest scoring ones trainers with intermediate scores to
for conducting training and inducted as excel through peer learning.
independent trainers after substantial (iii) Helped in ultimately achieving a larger
experience working in these pairs group of competent trainers at the local
level
Step 4 Continuous support and (i) A mix of 4 – 5 MTs with the highest and (i) Generated training opportunities for
guidance of Palghar MTs by intermediate scores conducted training Pune CTs to become competent and
Pune core trainers (CTs) courses for batches of health providers confident trainers and mentors
(ii) Presence of one Pune CT in every training (ii) Longer time frame for Palghat MTs to
batch, offering supportive supervision, receive supportive supervision, critical
clinical guidance, training pedagogy, and feedback, and appreciation
ensuring adherence to adult-leaner-centric
principles
Step 5 Regular quality assessment by (i) Structured quality assessment and critical (i) Proved necessary for ensuring
the UK experts (n=3) feedback sessions (virtual) to ensure clinical consistency of standardized training
acumen and standardized delivery of with expected quality throughout the
training content intervention, highlighting an essential
(i) Palghar MTs possessed essential clinical quality control step
knowledge but initially faced challenges in
adapting to the expected training pedagogy
(ii) Immediate corrective steps were taken based
on feedback
Step 6 Virtual refresher training for (i) Series of refresher sessions on essential (i) Demonstrated an effective and
master trainers maternal and newborn health skills over a resource-efficient method for delivering
period of 10 months (starting 6 months after training content and reinforcing
the ToT) using a virtual platform knowledge and skills without
(ii) Through case-based discussion interruptions, even during COVID-19

see whether the required primary management patient management. The training emphasized appropriate
was undertaken here before referring the cases.” referral practices and the use of a standardized referral
(Palghar MT [MO-PHC]) tool-situation background assessment recommendation
“I taught partograph plotting to all our staff nurses. (SBAR) (Shahid & Thomas, 2018). The Palghar MTs’
It helped everyone, including myself, to understand preparedness to manage referred in cases increased when
obstructed labor.” (Palghar MT [MO-Rural appropriate referral notes were sent with the patients
Hospital {RH}]) and because of appropriate primary-level management
The Palghar MTs appreciated learning new concepts, for undertaken before referral. This reduced delays in the
example, the danger response-airway breathing circulation secondary management of patients at the referral facility
(DR-ABC) approach to case assessment, which helped and increased the chances of their recovery and survival.
them to be more organized and efficient in systematic They also mentioned adapting to evidence-based practices

Volume 2 Issue 4 (2024) 6 https://doi.org/10.36922/ghes.2963