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IMAI Training. Training Methods. No PowerPoint; no specialists Skills-based learning Patient monitoring forms Patient education materials Exercises and drills Expert Patient-trainers. Active training with cases, interaction, clinical team building. What is the Expert Patient-Trainer?.
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Training Methods • No PowerPoint; no specialists • Skills-based learning • Patient monitoring forms • Patient education materials • Exercises and drills • Expert Patient-trainers
Active training with cases, interaction, clinical team building
What is the Expert Patient-Trainer? • A person living with HIV/AIDS (PLHA) and/or on ART • Trained to role-play a patient in specific HIV cases that were often (but not necessarily) similar to their own life experience • Trained to assess the important skills that the health worker should acquire from the clinical or aid training courses • Trained to give appropriate feedback to the health worker after the role-play, which allowed the health worker to practice these skills
Role of the Expert Patient-Trainer in IMAI • Worked in the skill stations as patients in a clinical encounter related to Chronic HIV Care/ART where the health workers would interact with them through their cases and practice important skills. • Simulated role-plays with the course facilitators in the classroom, so health workers could learn training material and important clinical health worker - patient interactions through the demonstrations • Shared personal experiences with HIV/ART with the course participants pertaining to topics discussed within the classroom environment
CASE 8 • You are a 47 year-old man, who tested HIV+ two years ago. You are a very heavy drinker and do not go to the clinic regularly. You come to the clinic today because you want ART. This is your first visit.
IF ASKED: • You are not taking any medications • Clinical Review: You do have a pain in your mouth when eating. You do not have any problems swallowing. You also have an itching rash around your nose and eyes. You do have a poor appetite and problems with sleeping. • You do not practice safer sex • You do not work but are able to do some things at home when you are motivated • You feel very lonely. Your wife and baby boy died last year, and you are living with friends.
________CUT HERE________ • Physical Exam: Current weight 65kg (last visit 8mo ago-77kg); Patient has white patches in his mouth which when checked can be scraped off and 1-2 mouth ulcers which are not deep or extensive. He also has a scaly rash around his nose and eyes.
CASE 33 • You are a married woman. You have tested HIV+ 2 months ago. You are on treatment for TB of the lungs, but otherwise are feeling quite healthy. Your husband is a policeman, but he has not been working for several months now, because he is too sick. You think he has HIV as well.
If asked • You are managing the TB drugs well. • Two days ago, you told him about your positive test. He became very angry and beat you. He does not want you to come to the clinic anymore. So you have to invent a story and come secretly.
Case specific questions • Checked adherence to TB drugs? • Discussed benefits and difficulties of disclosure? • Discussed safety? • Offered counselling for partner? • Advised on the importance of attending clinic regularly? • Discussed peer support? • Discussed community support? • Arranged follow up appointment next week?
EPT Challenges • Enthusiasm • Intimidation • Stigma and discrimination • Illness
Training plan—efficient, rapid, capable of supporting continuous training Group work: 10-12 participants 2 facilitators Skill stations Expert patients Card sorts Inpatient clinical practice Video cases, exercises (group) Outpatient clinical practice for Acute Care
Continuous Training Schedule Week 1 Week 1 Week 2 Week 2 Group 1 Group 2 Group 3 Group 4
