Pearce Jennifer, Mann Mala K, Jones Caryl, van Buschbach Susanne, Olff Miranda, Bisson Jonathan I
Department of Psychological Medicine, Cardiff University, Wales.
J Contin Educ Health Prof. 2012 Summer;32(3):215-226. doi: 10.1002/chp.21148.
Previous literature has shown that multifaceted, interactive interventions may be the most effective way to train health and social care professionals. A Train-the-Trainer (TTT) model could incorporate all these components. We conducted a systematic review to determine the overall effectiveness and optimal delivery of TTT programs.
We searched 15 databases. Reference lists and online resources were also screened. Studies with an objective follow-up measure collected over 1 week after the intervention were included. The intervention had to be based on a TTT model for health and social care professionals.
Eighteen studies met the inclusion criteria. TTT interventions varied greatly, ranging from didactic presentations to group discussions and role-plays. The heterogeneity of the studies and limited data prevented meta-analysis. A narrative review found that the TTT programs in 13 studies helped to increase knowledge, improve clinical behavior, or produce better patient outcomes. One study showed no effect. Three studies showed possible effect and one study showed that a CD-ROM training method was more effective than a TTT training method in improving participants' knowledge. Ratings of the studies' methodologies suggested moderate risk of bias, which limits interpretation of the results.
There is evidence that using a blended learning approach to deliver TTT programs--combining different techniques such as interactive, multifaceted methods and accompanying learning materials--can help to effectively disseminate and implement guidelines and curricula to health and social care professionals. However, further research is needed to determine the optimum "blend" of techniques.
既往文献表明，多方面的交互式干预可能是培训卫生和社会护理专业人员的最有效方式。培训培训师（TTT）模式可以纳入所有这些要素。我们进行了一项系统评价，以确定TTT项目的总体效果和最佳实施方式。
我们检索了15个数据库。还筛选了参考文献列表和在线资源。纳入在干预后1周以上收集客观随访指标的研究。干预必须基于针对卫生和社会护理专业人员的TTT模式。
18项研究符合纳入标准。TTT干预差异很大，从讲授式演示到小组讨论和角色扮演。研究的异质性和有限的数据妨碍了进行荟萃分析。一项叙述性综述发现，13项研究中的TTT项目有助于增加知识、改善临床行为或产生更好的患者结局。一项研究显示无效果。三项研究显示可能有效果，一项研究表明在提高参与者知识方面，光盘培训方法比TTT培训方法更有效。对研究方法的评分表明存在中度偏倚风险，这限制了对结果的解释。
有证据表明，采用混合学习方法实施TTT项目——结合交互式、多方面方法和配套学习材料等不同技术——有助于有效地向卫生和社会护理专业人员传播和实施指南及课程。然而，需要进一步研究以确定技术的最佳“组合”。
