Training Vietnamese diabetes specialists in facilitation methods as part of a train-the-trainer programme in diabetes management

Ulla Bjerre-Christensen, Frederik Persson, Eoin Noctor , Thy Khue Nguyen, Jane Rohde Voigt

Abstract

Type 2 diabetes is an important issue in Vietnam, with a doubling in prevalence to 5.4% of the population from 2002 to 2012. Upskilling general practitioners and internal medicine physicians to provide comprehensive, evidence-based diabetes treatment is a key step in addressing this emerging challenge.

The Vietnamese Association of Diabetes and Endocrinology and Steno Diabetes Center, with Ministry of Health support, deliver a train-the-trainer programme to build diabetes treatment capacity. In this model, an annual 2-day course is delivered to a group of endocrinologists (the ’trainers’). These doctors then form the faculty for a national training programme on evidence-based diabetes management for general practitioners and internal medicine physicians. In addition to diabetes management topics, various pedagogical methods, with an emphasis on participant interaction, sharing a constructivist approach to learning, were introduced to facilitate further training of healthcare professionals (HCPs). Here we present results from the training of endocrinologists (the ‘trainers’).

Methods

Quantitative and qualitative methods were used to gain information on participants’ background and experiences, and to place results in the appropriate context. Participants completed a pre-course questionnaire regarding their clinical practice, and two post-course questionnaires; one regarding their personal benefit from the course (5-point Likert scale); and another regarding individual learning experiences and potential barriers to implementation of the national training programme. Observations were conducted to determine the local approach to facilitation methods. A follow-up focus group interview with a subgroup of participants explored learning experiences and their application in practice.

Results,

Data were available on 88 of 91 participants. 64% were endocrinologists, while 31% were general physicans. Most (81%) had been in clinical practice ≥10 years, 74% practiced in an urban setting. 93% rated their personal benefit from the course at 4/5 or greater.

The questionnaire showed a preference for group discussion as a training method, with most respondents (61%) describing this as the most relevant learning experience in this course, while 58% also described using this as a training method when educating others. However, group work observations identified primarily passive teaching methods.

The focus group interview showed doctors attending the train-the-trainer course were highly motivated for participating in their own training, and initiating further HCP training. It identified challenges in conducting local training; contextual factors such as limited time and resources, and logistical challenges, emerged as common barriers to effective training.

Discussions

These results demonstrate the feasibility of engaging senior clinicians as trainers in upskilling other HCPs in diabetes management. Trainers are prepared for providing this training when motivated, trained systematically and inspired to use interactive training methods.

Observation demonstrated need for increased participant engagement in group work. Active facilitation techniques were discussed, and co-facilitation between local and external trainers ensured this was tailored to the local context. The training questionnaire and focus group interview indicate that participants valued discussion of varying pedagogical methods.

Clinically relevant, interactive approaches to training are vital for effective training of general physicians in diabetes management. Continued focus on addressing time and resource barriers is essential to ensure programme effectiveness.

OriginalsprogEngelsk
Publikationsdato2016
StatusUdgivet - 2016
Udgivet eksterntJa

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