Division of Gynecologic Oncology, Department of Obstetrics & Gynecology, National University of Singapore, Singapore.
Department of Family Medicine, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA.
Int J Gynecol Cancer. 2020 Aug;30(8):1124-1128. doi: 10.1136/ijgc-2020-001306. Epub 2020 Jul 23.
The objective of the study was to assess the effectiveness of training low-to-middle-income countries' local healthcare providers using the Train-the-trainers model in basic colposcopy for cervical cancer prevention.
This project was designed based on a philosophy known as Train-the-trainers which train proficient colposcopists and a cadre of local trainers who can continue to train and maintain their expertise in a self-sustaining system. The Train-the-trainers workshop is a 1-day program that focuses on three domains; knowledge, communication, and practical skills. Trainer candidates were given pre-course reading assignments and presentation decks. The expert trainers provided feedback on their presentations and tips on communication skills. The practical aspects of the training are supported by proficiency at the Loop Electro-excision procedure simulator and their responses to frequently asked questions.
Sixteen physicians from Vietnam attended the Colposcopy Workshop in 2018 and are used as controls. Eleven attended a workshop conducted by trainer candidates who went through the training program outlined above in 2019. A Wilcoxon Signed-ranks test indicated that differences between pre- and post-quizzes' scores were statistically significant in both the 2018 (Z=4.21, P=0.003, r=1.26) and 2019 cohorts (Z=3.558, P<0.001, r=0.89) while Mann-Whitney test did not detect the difference between the 2018 and 2019 cohorts, U=70.0, P=0.359, r=0.176. The subjective feedback scores from Year 2019 were similar to scores to Year 2018.
Our preliminary data did not highlight any differences between lectures delivered by expert trainers and lectures delivered by trainer candidates trained in the program. Train-the- trainers might be a more sustainable model for organically raising expertise to effectively provide cervical cancer screening and prevention in low-to-middle-income countries.
本研究旨在评估通过培训-培训者模式在基本宫颈癌预防中对中低收入国家当地医疗保健提供者进行培训的效果。
本项目基于培训培训者的理念设计，培训熟练的阴道镜检查者和一批当地培训师，他们可以在一个自我维持的系统中继续培训和保持专业知识。培训-培训者讲习班是为期一天的课程，重点关注三个领域：知识、沟通和实践技能。培训师候选人有课前阅读作业和演示文稿。专家培训师对他们的演示文稿提供反馈并提供沟通技巧提示。培训的实际方面得到环电切除术模拟器熟练程度和对常见问题解答的支持。
2018 年有 16 名越南医生参加了阴道镜检查研讨会，并用作对照组。2019 年，11 名医生参加了由经过上述培训计划培训的培训师候选人举办的研讨会。Wilcoxon 符号秩检验表明，2018 年（Z=4.21，P=0.003，r=1.26）和 2019 年（Z=3.558，P<0.001，r=0.89）两次测验的前测和后测得分之间的差异均具有统计学意义，而 Mann-Whitney U 检验未检测到 2018 年和 2019 年队列之间的差异，U=70.0，P=0.359，r=0.176。2019 年的主观反馈评分与 2018 年相似。
我们的初步数据并未突出显示由专家培训师和在该计划中接受培训的培训师候选人进行的讲座之间的任何差异。培训培训者可能是在中低收入国家有效提供宫颈癌筛查和预防方面提高专业知识的更可持续模式。
