Getting Real: Lessons from the Field 15 th 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 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 Research Linda L. Wright, M.D (O) (F)

Action Plan

Laerdal Prototype for HBB