“Learning is finding out what you already know “Learning is finding out what you already know. Doing is demonstrating that you know it. Teaching is reminding others that they know just as well as you do. We are all Learners, Doers, Teachers” R. Bach

Principles and Methods in Training: Training of Trainers (ToT) 17th EPIET introductory course Lazareto, Menorca, Spain 07 October 2011 Biagio Pedalino

What are we going to do? Define adults learning characteristics Present interactive teaching methodologies Design objectives for training activities List the necessary items to prepare a training course Practice designing a training course

Why? To improve our training skills To develop some of the core competencies for field epidemiologist in the EU as: Training To provide elements to achieve one of the EPIET objectives: to teach public health professionals

Basic Principles of Adults learning Take into consideration: Need to know what they are learning and why Values and pre-conceptions Experience (life experience) Tiredness, problems, etc. Are practical and problem solvers

Basic Principles of Adults learning Subject, matter relevant to his/her own purpose Learning by doing Applying information to current, real-world needs Exchanging feedback about experiences learners benefit a great deal from ongoing feedback around their experiences when applying new information and materials

“Self initiated learning involving the whole person (feelings as well as intellect) is the most pervasive and lasting type of learning.” (Knowles, 40)

… thus we privilege teaching methods which promote: Emphasis in the process instead the results Interactivity Active participation (interaction with others) Discussion Experience Appropriate motivational context Development of skills, attitudes and values Applied to real life problems Etc…

Design of Training Activities WHY and WHAT to teach Fundaments Objectives Contents Competences WHAT, HOW and WHEN to evaluate Program Knowledge Participants Procedures/skills WHEN to teach Attitudes Trainer Timing Methodology HOW to teach 9 9

We need a plan Why and What to teach? It provides information on the needs, objectives and content of training When to teach? It tells us how to order and sequence objectives and content How do you teach? Planning the activities (i.e. material and methods) What, how and when to evaluate? If you have achieved the desired objectives

What is missing so far ??? Our target population !!! Their needs Their motivation Their expectations

Teaching methods activity …get ready for some action…

Instructions You have been distributed in the room to constitute your “home group” (5 members with the same number, 1 to 8) Look in the room for other participants with the same name and constitute another group This is now your “expert group” (8 members with the same name)

HOME GROUP 5 persons each EXPERT GROUP 8 persons each 1 1 1 1 1 2 2 2 2 2 Mantel-Haenszel (1 2 3 4 5 6 7 ) 8 3 3 3 3 3 (1 2 3 4 5 6 7 ) Kruskal-Wallis 8 4 4 4 4 4 (1 2 3 4 5 6 7 ) Kaplan-Meier 8 5 5 5 5 5 Fisher (1 2 3 4 5 6 7 ) 8 6 6 6 6 6 (1 2 3 4 5 6 7 ) Snow 8 7 7 7 7 7 8 8 8 8 8 8

Tree activity With the material provided (1 pen, 2 sheets and 9 toothpicks): Try to make, with the toothpicks, as many trees as you can without repetitions Draw each new tree in the paper (definition of tree: 1 trunk + 3 or 4 branches)

Instructions Has to be a collaborative design SILENCE Laugh is allowed Free role distribution within the group You have 5 minutes!

Think in the group in 5´: Name a “reporter” and answer this questions: How many trees did you draw? What happend during the activity? What did you observed? Did you develop a group strategy? Any lesson learnt for the next group activity?

More questions: How did you feel in the group? What was your reaction to the task? Which was your role? How did you assign the roles? How did you feel about the person who was slow at seeing the solutions? If you were that person, how did you feel? Was there a climate that helped or hindered? How was the climate? Other observations, comments, learning points?

Next activity: 10´ Read the paper individually The group discuss and answer this questions: Explain briefly the technique When is it appropiate to use it? Which is the role of facilitator/moderator? - Take your notes, after you will explain this information in your “home group” (2 minutes each technique)

Home group. 10´: Split from the expert group and go back to your “home group” (all members with the same number) Name a “timekeeper” to control the time Each “expert” share his/her knowledge built in the previous group 2 minutes per expert

Now you know more about: Active Learning Methods Phillips 6-6 Role Play Snow Ball Brainstorming Jigsaw/Puzzle Ice breakers

Description of Jigsaw Technique Group-work method for teaching, learning and participating in group learning activities Cooperative learning strategy enables each participant of a “home” group to specialize in one aspect (“expert”) of a learning unit to resolve a task or class project

Example of Jigsaw Technique Home group 1 Home group 2 Home group 3 Home group 4 … Expert group 1 Expert group 2 Expert group 3 Expert group 4 … Picture from: http://serc.carleton.edu/NAGTWorkshops/coursedesign/tutorial/jigsaw.html

What are the benefit of the Jigsaw? Efficient way to learn Encourages listening, engagement, and empathy by giving each member of the group an essential part to play in the activity (i.e. to acquire an expertise) Group members must work together as a team to accomplish a common goal Each person depends on all the others No student can succeed completely unless everyone works well together as a team

What are the benefit of the Jigsaw? Interpersonal and Social skills Leadership Decision-making Trust-building Communication Conflict-management skills Etc. FG,Atilim University, 2007

Core competency benefits gained from using the Jigsaw technique PARTICIPANTS WILL… have the opportunity to teach themselves, instead of having material presented to them have practice in peer teaching, which requires that they understand the material at a deeper level contribute meaningfully to a group discussion while developing an area of expertise within the overall project M. Kamensky, 2010

Ten Core competency benefits gained from using the Jigsaw technique have an opportunity to demonstrate a high level of personal responsibility think creatively and reflectively, devising new, differentiated ways of approaching, teaching, and presenting material work towards a common goal by sharpening their cooperative and teamwork skills. M. Kamensky, 2010

Training activity You are a fellow in your public health institute. Your supervisor asks you to prepare a course. In groups of 8 (expert groups) with two facilitators and following the template provided, you are required to prepare a training activity (45 minutes) The “reporter” of the group will summarize the training developed to his/her group

Design of Training Activities WHY and WHAT to teach Fundaments Objectives Contents Competences WHAT, HOW and WHEN to evaluate Program Knowledge Participants Procedures/skills WHEN to teach Attitudes Trainer Timing Methodology HOW to teach 31 31

TRAINERS Take into account to make an assessment about: motivation, needs, expectations of the target possible “difficulties” for learning (travelling, family responsibilities, cost, time, language, materials, different levels, nationalities, etc.)

Questions about the target group: Which are the training needs of the target group? Which is their knowledge level about the content? Do you know which competences should they acquire? What do you expect that they should learn after the training course? Can you describe suitable attitudes that the target might acquire during the training? And procedure skills?

General objective Global goal of the course: Give an overview of the main aspects of vaccination issues in public health Strengthen participant knowledge and skills related to surveillance of vaccine preventable diseases (VPD) and immunization programmes Provide training and practical experience in intervention epidemiology at the national centres for surveillance and control of communicable diseases in the EU and Norway Explain the main pedagogical aspects for training activities

Objectives The three domains of learning: Cognitive/Knowledge domain that emphasizes thinking and knowledge (concepts) Skills domain featuring doing (Psychomotor). Manual or physically skills and performance of actions Attitude domain highlighting attitudes, values, interests, attention, concern, responsibility, ability to listen, respond and demonstrate interactions with others 35

Cognitive/Knowledge domain Examples: Describe the concepts of virology, bacteriology, immunology related to the different test formats. Select, prioritize and structure information relevant to the decision process. Define the advantages and limitations of forecasting. Evaluate vaccination programmes, surveillance of vaccine preventable diseases, vaccine uptake, vaccine safety, immune status, sero-epidemiology and vaccine effectiveness Explain principles for designing information and vaccination campaigns Design a training activity

Skills domain Develop basic computer programmatic and analytical skills Assess the magnitude of an event in terms of severity, extension in time and in space, affected population, probability of spread, existence of control measures, etc Apply criteria and algorithms to decide on its reporting at the EU (EWRS criteria) Carry out analysis for cohort and (matched) case-control studies, including stratified and multivariable analysis. Collect an adequate specimen Perform interactive teaching techniques

Attitude domain Develop a European network of public health epidemiologist with common methods and objectives Be comfortable in the communication of a decision Encourage collaboration between groups to share information Implement collaborative activities and teamwork with other professionals Realize the ethics behaviour Improve active listening Develop emotional skills (emphaty, assertive, etc.) Critically appraise and cope with the consequences of wrong decisions Negotiate a project Improve team work skills

Qualities of an objective Relevant Specific Observable and measurable

Objectives There are important components writing objectives: the action verb (Infinitive) One verb per objective (recommended) 3) Measurable 4) Intended audience At the end of the module/course, participants will be able to: Waller, K.

Choice of an active verb Open to less interpretation and easy to observe or measure: Describe Resolve List Compare Evaluate Identify Design Explain Select Distinguish Construct Solve Open to many interpretation and difficult to observe or measure: Know Understand Believe Have faith in Be familiar with Appreciate Be aware of Have a good grasp of Have a knowledge of Realise the significance of Be interested in Better Arlette Communier

Examples Explain the objective of a surveillance system List the mandatory diseases Communicate with general and professional public Formulate a case definition Report the data weekly or monthly according to the situation Use the notification forms Write situation reports Encourage collaboration between multidisciplinary groups Promote communication between departments ….

For your activity Write, at least, two objectives for knowledge and skills and one for attitude Choose the content of the course related with the topic, target group, etc. Time. Specify the duration of the course in hours (10h, 20h, 30h, etc)

For your activity Learning material/method: pre-module workbook; facilitator guidelines, PowerPoint presentation, flip chart template, handouts and references. Ice breaker, formal presentations, Role Playing, Phillips 66, Snow bowling, Peer and group discussion, practice in lab, etc. Competencies A competency is a combination of knowledge, skills, attitudes, values, motivation and abilities that a professional must demonstrate and that are critical to perform work effectively Example: Implement public health programmes: translate policy into public health practice

Training activity You are a fellow in your public health institute. Your supervisor asks you to prepare a course. In groups of 8 (expert groups) with two facilitators and following the template provided, you are required to prepare a training activity (45 minutes) The “reporter” of the group will summarize the training developed to his/her group

Design of Training Activities WHY and WHAT to teach Fundaments Objectives Contents Competences WHAT, HOW and WHEN to evaluate Program Knowledge Participants Procedures/skills WHEN to teach Attitudes Trainer Timing Methodology HOW to teach 47 47

Evaluation Needs Adequation between: Before the implementation Planification Process Trainees During the implementation Survey, discussion, one minute paper, etc. Impact After the training Arlette Communier

References BIGGS, J. (2005): Calidad del aprendizaje universitario. Madrid: Narcea. ECDC Core competences http://www.ecdc.europa.eu/en/publications/Publications/Forms/ECDC_DispForm.aspx?ID=108 ATHERTON J S (2010) Learning and Teaching; Angles on learning, particularly after the schooling years [On-line] UK: Available: http://www.learningandteaching.info/learning/index.htm Interactive learning techniques: http://www.calstatela.edu/dept/chem/chem2/Active/ Knowles, Malcolm, Holton, Elwood, Swanson, Richard, The Adult Learner, fifth edition, Gulf Publishing Company, 1998. http://www.texascollaborative.org/PDFs/Active%20Learning%20Strategies_02.pdf Morable, L.(2000): Using active learning techniques. On line: http://www.texascollaborative.org/PDFs/Active%20Learning%20Strategies_02.pdf Waller, K. Writing instructional objectives. On line http://www.naacls.org/docs/announcement/writing-objectives.pdf

Thank you for your attention “The nicest thing about not planning is that failure comes as a complete surprise”  John Preston