To apply the continuous quality improvement model commonly associated with the business sector to entrylevel athletic training education program accreditation.
We applied athletic training educational program accreditation as a tool for ensuring quality in the entrylevel athletic training education programs accredited by the Commission on the Accreditation of Allied Health Education Programs. Literature from the business, education, and athletic training fields is integrated to support this paradigm shift in athletic training education.
The advent of mandated entry-level athletic training educational program accreditation has forced institutions to evaluate their educational programs. Accreditation will promote continuous quality improvement in athletic training education through mechanisms such as control measures and process improvement.
Although accreditation of entry-level athletic training education programs has created some dissonance among athletic training professionals, it will strengthen the profession as a whole. Athletic training educators must capture the synergy generated from this change to ensure quality educational experiences for all our students as we move forward to secure a strong position in the allied health care market.
process improvement; Commission on Accreditation of Allied Health Education Programs (CAAHEP); Joint Review Committee on Educational Programs in Athletic Training (JRC-AT); leadership
To develop and implement a continuing pharmacy education (CPE) program at Kaiser Permanente Colorado (KPCO)
To address the continuing education needs of its diverse pharmacy staff, an internal continuing pharmacy education (CPE) program was developed. The pharmacy department became an accredited provider by the Accreditation Council for Pharmacy Education (ACPE). Live, interactive, and evidence-based CPE programs, presented by highly qualified internal staff members, utilized videoconferencing and a Web-based learning management system. Cross-accreditation of medical and pharmacy educational programs was offered to KPCO staff members.
Annual needs assessments were conducted to ensure the provision of relevant educational topics and to assess learning needs. To demonstrate outcomes of the CPE programs, 2 methods were utilized: objective effectiveness assessment and knowledge acquisition assessment. This program met the objectives for CPE activities a large majority of the time (usually over 90%), demonstrated statistically significant (p < 0.05) improvement in knowledge from before to after the CPE activity in 11 of 13 questions asked, and minimized the cost to acquire CPE credit for both the pharmacy department and its staff members.
The KPCO continuing pharmacy education program has developed a high quality and cost-favorable system that has resulted in significant improvements in attendee knowledge.
continuing education; videoconferencing
Breast and cervical cancer continue to represent major health challenges for African American women. among Caucasian women. The underlying reasons for this disparity are multifactorial and include lack of education and awareness of screening and early detection. Traditional educational methods have enjoyed varied success in the African American community and spawned development of novel educational approaches. Community based education programs employing a variety of educational models have been introduced. Successful programs must train and provide lay community members with the tools necessary to deliver strong educational programs.
The Witness Project is a theory-based, breast and cervical cancer educational program, delivered by African American women, that stresses the importance of early detection and screening to improve survival and teaches women how to perform breast self examination. Implementing this program in the Buffalo Witness Project of Buffalo required several modifications in the curriculum, integration of non-traditional learning tools and focused training in clinical study participation. The educational approaches utilized included repetition, modeling, building comprehension, reinforcement, hands on learning, a social story on breast health for African American women, and role play conversations about breast and cervical health and support.
Incorporating non-traditional educational approaches into the Witness Project training resulted in a 79% improvement in the number of women who mastered the didactic information. A seventy-two percent study participation rate was achieved by educating the community organizations that hosted Witness Project programs about the informed consent process and study participation.
Incorporating non-traditional educational approaches into community outreach programs increases training success as well as community participation.
Continuing medical education (CME) is important for professional development, to improve doctors’ clinical performance that ultimately influences the quality of the health outcomes. In the presence of an increasing number of family physicians serve in the primary health care system upon graduation in Oman make us to consider the meta-cognition of the leaner and engaged them in learning process. The purpose of this paper is to examine ways of improving the continuing education methods for the physicians.
To assess the preferred method of continuing education for primary health care physicians.
We conducted a program evaluation among a group of general physicians who were involved in some of the activities in continuing education at end of their program in the Muscat region health centres in Oman. The main outcome measure was to study the preferred method for CME.
The majority of the participants believe that continuing medical education improves their practice. In addition, the finding suggests that small group learning and combination of methods are the preferred methods of continuing education for primary health care physicians.
Interactive small group learning is shown to be more effective to achieve the learning objectives and ultimately improve practice. Practice-based small group learning is the method we recommended.
Continuing medical education; interactive learning; small group; professional education; problem-based learning
Objectives. To evaluate hospital and outpatient pharmacists’ pharmacogenomics knowledge before and 2 months after participating in a targeted, case-based pharmacogenomics continuing education program.
Design. As part of a continuing education program accredited by the Accreditation Council for Pharmacy Education (ACPE), pharmacists were provided with a fundamental pharmacogenomics education program.
Evaluation. An 11-question, multiple-choice, electronic survey instrument was distributed to 272 eligible pharmacists at a single campus of a large, academic healthcare system. Pharmacists improved their pharmacogenomics test scores by 0.7 questions (pretest average 46%; posttest average 53%, p=0.0003).
Conclusions. Although pharmacists demonstrated improvement, overall retention of educational goals and objectives was marginal. These results suggest that the complex topic of pharmacogenomics requires a large educational effort in order to increase pharmacists’ knowledge and comfort level with this emerging therapeutic opportunity.
pharmacogenomics; continuing education; genetic testing; survey; personalized medicine
In 1973 the division of continuing medical education of the University of Saskatchewan initiated a 3-year study to determine the effect of hospital-based education on the prescribing accuracy of physicians. This study was undertaken in response to an urgent need to develop more effective methods of continuing medical education and improved techniques of measuring their effectiveness. The educational program focused on common prescribing problems that had previously been defined by experts in the field. Problem frequency was determined by the monitoring of hospital records prior to institution of the educational program and at 3, 6 and 12 months after the program had concluded; this was found to be a satisfactory method of identifying educational needs and is considered to provide a measure of the quality of medical care. Fifteen physicians at three rural hospitals participated in the study. Seventeen physicians at two similar hospitals served as controls. The average problem frequency for topics selected at the study hospitals was reduced by 63% (the percentage of possible improvement), whereas at the control hospitals the frequency of the same problems declined by 32% over the same period. The results of this study provide evidence that an intensive, problem-based program on therapeutics can improve physician performance.
To fulfill a need for convenient and effective continuing education for pharmacists throughout Wisconsin by developing a pharmacy continuing education program using 2 different methods for distance education: audio teleconferencing and CD-ROM.
Eighty pharmacists were recruited from a 2003 University of Wisconsin distance education program, 47 of whom participated in the course using the traditional audio teleconference method, and 33 of whom participated using a home study CD-ROM containing the same material presented in the teleconference. Volunteers were required to complete a pretest, a first posttest immediately following completion of the continuing education course, a second posttest 1 month following the conclusion of the course, and an evaluation.
The CD-ROMs were a more acceptable method for distance education than audio teleconferencing and resulted in better retention of the course information.
These study results can help coordinators of continuing pharmaceutical education programs to determine the most effective and acceptable method for future distance-education opportunities.
distance education; continuing education; audio teleconferencing; CD-ROM instruction
The concept of asthma self-management began in asthma camps in the 1970s. Today all asthma camps are required to provide an educational asthma self-management program. The interaction between children and educators is brief, and if the children do not continue in an associated program after camp, the benefits may be lost. Open Airways, the first program developed specifically for minority children, has been the prototype for community asthma self-management. School-based intervention programs have incorporated asthma education into the health curriculum. Some asthma education programs include an emphasis on the environment. Another approach is to develop intervention projects with parents, as in the Head Start program. This program has been very effective in increasing early recognition of asthma and decreasing recidivism in a high-risk population. Another type of project addressed the reading ability and reading comprehension of asthmatic children. Improvement in reading skills resulted in a 47% decrease in asthma recidivism. After 18 months, there were only two hospitalizations among the enrolled participants. Asthma self-management programs that are most effective for inner-city children provide an interactive, culturally relevant form of asthma education and address issues such as literacy and continuity.
New approaches are often introduced to the neonatal intensive care unit (NICU) and other areas of the health service in either a haphazard or cataclysmic fashion. The needs of staff education are often addressed incompletely or too late. Rarely is education assessed after the introduction of a major change. We changed the basis of our NICU respiratory support. We conducted a major educational and support program before this intervention. This study documented and assessed the educational components of this change in our health service provision.
Senior medical and nursing staff attended training abroad and an education program was applied for one year prior to the change. Multidisciplinary educational support for doctors, nurses and allied health was continued after the change. Assessment was by anonymous questionnaire, prior to change, at one and at nine months. Our hypothesis was that dissatisfaction with education would be greatest at one month.
Both theory education and practical education aspects of the new approach were rated as good to very good and this did not change with time. Difficulty of applying the technique was rated as ambivalent initially but decreased significantly over 9 months until it was rated easy to very easy (p < 0.001). Over all, the change was rated by staff as beneficial, both at the end of the education period and at nine months, with no decrease at one month.
If education and training reaches all staff, with a system of mutual and continued support, even large changes in clinical practice can be achieved without the dissatisfaction with the educational process that is often otherwise seen.
PROBLEM ADDRESSED: Recruitment and retention of physicians appropriately trained for rural practice in Canada continues to be a serious challenge. We describe three integrated educational programs at the University of Alberta that aim to increase students' and residents' participation in rural health care and encourage them to take up practice in rural areas. OBJECTIVES OF PROGRAM: To expand and enrich rural educational experiences at undergraduate and postgraduate levels and to supplement family medicine postgraduate education with a third-year special-skills program for rural practice. MAIN COMPONENTS OF PROGRAM: Main components are sustained, reliable funding from the Government of Alberta for the Rural Physician Action Plan; adequate infrastructure to support the program; and commitment by university faculty, rural physicians, and communities. CONCLUSION: The rural-based educational programs have allowed more than 95% of medical students to gain experience in rural areas. The number of family medicine residents doing rural rotations has doubled, and the length of experiences in rural practice has increased fourfold. The third-year special-skills training for rural practice has expanded greatly, and at least 26 of 49 participants have gone on to enter rural practice. In more than 30 rural Alberta communities, 56 physicians have had an important influence on the training of medical students and family medicine residents.
The demand for health professionals continues to increase, partially due to the aging population and the high proportion of practitioners nearing retirement. The University of British Columbia (UBC) has developed a program to address this demand, by providing support for internationally trained Physiotherapists in their preparation for taking the National Physiotherapy competency examinations.
The aim was to create a program comprised of the educational tools and infrastructure to support internationally educated physiotherapists (IEPs) in their preparation for entry to practice in Canada and, to improve their pass rate on the national competency examination.
The program was developed using a logic model and evaluated using program evaluation methodology. Program tools and resources included educational modules and curricular packages which were developed and refined based on feedback from clinical experts, IEPs and clinical physical therapy mentors. An examination bank was created and used to include test-enhanced education. Clinical mentors were recruited and trained to provide clinical and cultural support for participants.
The IEP program has recruited 124 IEPs, with 69 now integrated into the Canadian physiotherapy workforce, and more IEPs continuing to apply to the program. International graduates who participated in the program had an improved pass rate on the national Physiotherapy Competency Examination (PCE); participation in the program resulted in them having a 28% (95% CI, 2% to 59%) greater possibility of passing the written section than their counterparts who did not take the program. In 2010, 81% of all IEP candidates who completed the UBC program passed the written component, and 82% passed the clinical component.
The program has proven to be successful and sustainable. This program model could be replicated to support the successful integration of other international health professionals into the workforce.
International health graduates; Educational program development; Program evaluation; Integration
This study investigated the relationship between ethics education and training, and the use and usefulness of ethics resources, confidence in moral decisions, and moral action/activism through a survey of practicing nurses and social workers from four United States (US) census regions.
The sample (n = 1215) was primarily Caucasian (83%), female (85%), well educated (57% with a master’s degree). no ethics education at all was reported by 14% of study participants (8% of social workers had no ethics education, versus 23% of nurses), and only 57% of participants had ethics education in their professional educational program. Those with both professional ethics education and in-service or continuing education were more confident in their moral judgments and more likely to use ethics resources and to take moral action. Social workers had more overall education, more ethics education, and higher confidence and moral action scores, and were more likely to use ethics resources than nurses.
Ethics education has a significant positive influence on moral confidence, moral action, and use of ethics resources by nurses and social workers.
ethics education; moral action; ethics consultation
The present system of education for medical library practice in the United States consists of four major components: graduate degree programs in library science with specialization in medical librarianship; graduate degree programs in library science with no such specialization; postgraduate internships in medical libraries; continuing education programs. Data are presented illustrating the flow of graduates along these several educational pathways into medical library practice.
The relevance of these educational components to the current medical library work force is discussed with reference to manpower data compiled for Ohio. The total number of medical library personnel in Ohio in 1968 is 316. Of this total, only forty-two (approximately 14 percent) have received any formal library training. Seventy persons have only a high school education. From these figures, it is concluded that there is no standard or essential qualification which is universally accepted as educational preparation for work in medical libraries; that the comparative sophistication of the educational programs in medical librarianship has yet to be reflected widely in general medical library practice; that an increasingly large number of non-professional or ancillary personnel are being, and will continue to be, utilized in medical libraries; that large numbers of untrained persons have sole responsibility for medical libraries; and that appropriate educational programs will have to be designed specifically for this type of personnel.
This article describes the Healthy Minds/Healthy Children Outreach Service (HMHC), an ongoing clinical and educational outreach service which makes use of technology to bridge geographical barriers to help build capacity in front-line professionals to meet children’s mental health needs in rural areas.
A description of the HMHC clinical consultation and educational services is given. Utilization patterns of these services are reviewed.
Clinical service accounts for approximately 1/3 of the service’s activities. Continuing professional development has experienced strong growth since the program’s inception eight years ago. The majority of consultees and continuing professional development users have been non-physicians.
Future challenges for program development include increasing physician involvement and continuing to adapt the program’s continuing education program to the multidisciplinary professionals who provide support to children in rural areas. Measuring the program’s outcome in terms of its effect on clinical care through knowledge transfer has been difficult to do because of methodological research challenges, while successful research in this area will be helpful to determine how collaborative care models can help in the provision of mental health services to youth in rural communities. The growth of collaboration across various professional disciplines and service sectors demonstrates that programs like HMHC can be effective in meeting some of the unmet needs in providing mental health services to children and youth.
capacity-building outreach service; youth mental health; service de formation professionnelle; santé mentale des enfants et des adolescents
To investigate whether a multimethod approach, including a new position dedicated to graduate medical education (GME) educator, online education modules, and program file audits, was associated with quality improvement in our residency programs.
Data related to GME audits, residency review committee citations and cycle lengths were entered into a database. We conducted statistical analyses and calculated effect sizes to explore whether these resources were associated with program quality, as measured by maintaining necessary program policies and files, implementation of multiple assessments, increased residency review committee cycle lengths, and reductions in the number of citations.
The statistical analyses support the implementation of the GME educator, file audits, and online courses designed to improve the quality of residency education.
The GME office will continue to conduct audits, develop online learning resources, and provide one-on-one communication between the GME educator and program coordinators and directors. Our approach could serve as a model for other institutions interested in enhancing institutional oversight and the quality of their programs.
Many have called for ambulatory training redesign in internal medicine (IM) residencies to increase primary care career outcomes. Many believe dysfunctional, clinic environments are a key barrier to meaningful ambulatory education, but little is actually known about the educational milieu of continuity clinics nationwide.
We wished to describe the infrastructure and educational milieu at resident continuity clinics and assess clinic readiness to meet new IM-RRC requirements.
National survey of ACGME accredited IM training programs.
Directors of academic and community-based continuity clinics.
Two hundred and twenty-one out of 365 (62%) of clinic directors representing 49% of training programs responded. Wide variation amongst continuity clinics in size, structure and educational organization exist. Clinics below the 25th percentile of total clinic sessions would not meet RRC-IM requirements for total number of clinic sessions. Only two thirds of clinics provided a longitudinal mentor. Forty-three percent of directors reported their trainees felt stressed in the clinic environment and 25% of clinic directors felt overwhelmed.
The survey used self reported data and was not anonymous. A slight predominance of larger clinics and university based clinics responded. Data may not reflect changes to programs made since 2008.
This national survey demonstrates that the continuity clinic experience varies widely across IM programs, with many sites not yet meeting new ACGME requirements. The combination of disadvantaged and ill patients with inadequately resourced clinics, stressed residents, and clinic directors suggests that many sites need substantial reorganization and institutional commitment.New paradigms, encouraged by ACGME requirement changes such as increased separation of inpatient and outpatient duties are needed to improve the continuity clinic experience.
clinic; resident education; ACGME; primary care
Healthcare providers serving rural populations face numerous barriers to accessing educational programming. Difficulties accessing continuing professional education contribute to the challenges of providing comprehensive health care in the rural setting. Telehealth can inform and educate rural providers about changes in medicine and evidence-based practices, both of which may help them provide quality care. The Native People for Cancer Control Telehealth Network used telehealth technology to deliver a cancer education series in 2008 and 2009 to Washington and Alaska rural healthcare providers who treated American Indians and Alaska Native people. Customizing presentation content to providers’ educational needs encouraged attendance. Evaluation indicated videoconferencing technology was positive received for delivery of the educational sessions. This series demonstrated videoconferencing was a satisfactory means of delivering real-time, interactive cancer educational programming to providers who might not otherwise have access to such programs.
Cancer education; Rural healthcare providers; Telehealth
The development of a student exchange program was an essential part of the cooperation between the Medical Schools of the University of Goettingen (Germany) and the University of Thrace in Alexandroupolis (Greece). The student exchange program started in 2008 and was performed once a year. The experiences of this program and the feedback of participants are presented.
Although organized by the Dept. of Thoracic, Cardiac, and Vascular Surgery, the approach of the program was multidisciplinary. Participants also attended Continuous Medical Education activities primary addressed to physicians. At the end of the program, the participants evaluated the program anonymously. The educational units were rated via a 4-grade system. Additionally, it was possible to comment both positive and negative aspects of the program.
Twenty-nine educational units were evaluated. The practical teaching units yielded a better result than the classical teaching units (93% of practical units were evaluated as “very good” vs. 74% of lectures/seminars). The Continuous Medical Education activities were evaluated less favorable (only 61% were evaluated as “very good”).
The student exchange program enhanced effective teaching and learning. Courses supporting practical medical skills were extremely positive evaluated. Continuous Medical Education activities are not suitable for students and therefore, we do not include such an event anymore. Additionally, the program created an excellent forum for contact and communication between the students of the two universities.
Medical education; Medical student; Communication; International cooperation; Cardiovascular
In 2009, occupational health nursing faculty and professionals at the University of Washington developed an innovative continuing nursing education offering, the OHN Institute. The OHN Institute was designed to meet the following objectives: (1) extend basic occupational health nursing training to non-occupational health nurses in Federal Region X, (2) target new occupational health nurses or those who possessed little or no advanced education in occupational health nursing, and (3) offer a hybrid continuing nursing education program consisting of on-site and distance learning modalities. Evaluation findings suggested that the various continuing nursing education modalities and formats (e.g., asynchronous vs. synchronous, online modules vs. live modules) were essentially comparable in terms of effectiveness. Perhaps most importantly, the OHN Institute evaluation demonstrated that quality continuing nursing education outcomes for occupational health nurses depended largely on knowledgeable and engaging faculty and a compelling vision of desired outcomes, including the application of learned content to professional practice.
The Ochsner Clinic Foundation Anesthesiology Residency Program is the oldest continuously accredited anesthesiology residency program in the state of Louisiana. As the American College of Graduate Medical Education has developed residency training requirements, so has the Ochsner training program evolved from a structure- and process-based program to an outcomes-based program. The author, associated with the program since 1983, reviewed Program Information Forms from 1971 to the present to track the evolution of the anesthesiology residency training program. The Accreditation Council of Graduate Medical Education demanded allocation of resources to residency training and mandated the demonstration of outcomes of training. The Ochsner Clinic Foundation Anesthesiology Residency Program has kept pace with these demands. The trend for graduate performance on written examinations has been upward. Fifty years ago, graduates practiced locally, but graduates now practice throughout the United States. Many completed fellowship training at increasingly higher profile institutions.
Anesthesiology; medical education; residency education
Continuing Education (CE) for chiropractors is mandatory for licensure in most North American jurisdictions. Numerous chiropractic colleges have begun collaborating with universities to offer master's degree programs. Distance education master's degree programs may be desirable to allow full-time practicing doctors to further their post-graduate education. The present survey sought to answer three questions. First, what is the level of satisfaction of chiropractors with their continuing education? Second, what is the level of interest of chiropractors in online master's degree programs? Lastly, what is the response rate of chiropractors to an online survey?
An online survey consisting of 22 multiple choice questions was e-mailed to 1000 chiropractors randomly selected from the mailing list of an online chiropractic newsletter. Upon completion of the questionnaire, participants' answers were saved on a secure site. Data analysis included evaluation of the demographic characteristics of the respondents, their opinions of and patterns of taking CE including online education, preferred learning formats, and their interest in proposed online master's degree programs. A survey response rate was determined.
Nearly 86% of respondents felt their previously completed CE courses were either somewhat or extremely satisfactory. Over ninety percent of respondents who had completed online or distance CE coursesfound them to be somewhat or extremelysatisfactory. Almost half the respondents indicated that they most preferred online distance learning, while 34.08% most preferred face-to-face interaction. Fifty-three percent of respondents indicated an interest in starting a master's degree program; however 70.46% of respondents were interested in an online master's degree program that would offer CE credit. A response rate of 35.8% was obtained.
Satisfaction among chiropractors with CE programs is high. The notion of completing a part-time online master's degree (or online combined with face-to-face interaction) appears to be popular among respondents, with a M.Sc. in Chiropractic Sciences being the most popular of those mentioned. Online surveys are a viable method of obtaining opinion in a cost and time efficient manner; there are some sources of bias involved in this type of research, and numerous steps need to be taken to obtain a suitable response rate.
PROBLEM BEING ADDRESSED: In response to the accreditation guidelines of the College of Family Physicians of Canada's (CFPC) Task Force on Intraining Evaluation, the Department of Family Medicine at McGill University implemented a faculty advisor program on July 1, 1993. OBJECTIVE OF PROGRAM: In addition to meeting the requirements of the CFPC, the faculty advisor program was developed to foster communication between residents and faculty, increase opportunities for feedback, promote self-directed learning, and personalize the educational experience of trainees. MAIN COMPONENTS OF PROGRAM: Residents were assigned an advisor. They were expected to meet their advisors monthly to discuss educational objectives, performance, career planning, and any problems. Educational plans were to be completed at each meeting. CONCLUSIONS: Feedback from advisors and residents has been positive, with both groups expressing overall satisfaction with the program. The faculty advisor program will continue but will be modified to address problems identified and better meet the needs of faculty and residents.
The field of Biomedical and Health Informatics (BMHI) continues to define itself, and there are many educational programs offering ‘informatics’ degrees with varied foci. The goal of this study was to develop a scheme for systematic comparison of programs across the entire BMHI spectrum and to identify commonalities among informatics curricula.
Guided by several published competency sets, a grounded theory approach was used to develop a program/curricula categorization scheme based on the descriptions of 636 courses offered by 73 public health, nursing, health, medical, and bioinformatics programs in the USA. The scheme was then used to compare the programs in the aforementioned five informatics disciplines.
The authors developed a Course-Based Informatics Program Categorization (CBIPC) scheme that can be used both to classify coursework for any BMHI educational program and to compare programs from the same or related disciplines. The application of CBIPC scheme to the analysis of public health, nursing, health, medical, and bioinformatics programs reveals distinct intradisciplinary curricular patterns and a common core of courses across the entire BMHI education domain.
The study is based on descriptions of courses from the university's webpages. Thus, it is limited to sampling courses at one moment in time, and classification for the coding scheme is based primarily on course titles and course descriptions.
The CBIPC scheme combines empirical data about educational curricula from diverse informatics programs and several published competency sets. It also provides a foundation for discussion of BMHI education as a whole and can help define subdisciplinary competencies.
Little is known regarding the feasibility and efficacy of an online continuing education program for oncology nurses. The Multiple Myeloma Mentorship Program, a quality improvement project for the Institute for Medical Education and Research, was designed to meet the educational needs of oncology nurses caring for patients with multiple myeloma. Twenty-five expert nurses with expertise in multiple myeloma from 23 cancer centers in the United States partnered with 50 oncology nurses in an electronic format from July 2009 to January 2010. The purpose of the program was to educate oncology nurses about the latest treatments and strategies for optimal side-effect management for patients with multiple myeloma. Nurse mentees selected their preferred form of learning—webcast, in-person speaker, or monograph. Two live webcasts allowed for didactic discussion between mentors and mentees. During and after the program, mentors conducted informal, unscripted interviews with nurse participants to determine preferred learning format, challenges, and implications for practice. Twelve nurses preferred Web-based learning to in-person presentations, citing flexibility and convenience as reasons for that choice. Time constraints with Web-based and in-person learning were a barrier to nurse mentees completing assigned modules. Several nurses implemented practice changes as a result of the program. Nurses who participated in the mentorship program were satisfied with the content. Learning styles and format should be considered in future mentorship programs.
Despite ample evidence that HIV has entered the general population, most HIV awareness programs in India continue to neglect rural areas. Low HIV awareness and high stigma, fueled by low literacy, seasonal migration, gender inequity, spatial dispersion, and cultural taboos pose extra challenges to implement much-needed HIV education programs in rural areas. This paper describes a peer education model developed to educate and empower low-literacy communities in the rural district of Perambalur (Tamil Nadu, India).
From January to December 2005, six non-governmental organizations (NGO's) with good community rapport collaborated to build and pilot-test an HIV peer education model for rural communities. The program used participatory methods to train 20 NGO field staff (Outreach Workers), 102 women's self-help group (SHG) leaders, and 52 barbers to become peer educators. Cartoon-based educational materials were developed for low-literacy populations to convey simple, comprehensive messages on HIV transmission, prevention, support and care. In addition, street theatre cultural programs highlighted issues related to HIV and stigma in the community.
The program is estimated to have reached over 30 000 villagers in the district through 2051 interactive HIV awareness programs and one-on-one communication. Outreach workers (OWs) and peer educators distributed approximately 62 000 educational materials and 69 000 condoms, and also referred approximately 2844 people for services including voluntary counselling and testing (VCT), care and support for HIV, and diagnosis and treatment of sexually-transmitted infections (STI). At least 118 individuals were newly diagnosed as persons living with HIV (PLHIV); 129 PLHIV were referred to the Government Hospital for Thoracic Medicine (in Tambaram) for extra medical support. Focus group discussions indicate that the program was well received in the communities, led to improved health awareness, and also provided the peer educators with increased social status.
Using established networks (such as community-based organizations already working on empowerment of women) and training women's SHG leaders and barbers as peer educators is an effective and culturally appropriate way to disseminate comprehensive information on HIV/AIDS to low-literacy communities. Similar models for reaching and empowering vulnerable populations should be expanded to other rural areas.