Plan
Defining an Appropriate Plan
Selecting Appropriate Training Methods
Choosing Audiovisual Materials
Crafting a Realistic and Effective Training Plan
To develop an effective training plan that achieves the
point of the educational session: i.e., to make changes in
knowledge, attitudes, behaviors, and skills, a number of key
questions must be answered. Some of these questions will be
addressed in the needs assessment. The answers to these
questions will affect the content, format, and logistics of
the training. The following questions are a guide.
Questions
Who are your participants?
What is their educational level?
What is their experience and skill level?
What gender and age are they?
Are they employed?
What kind of work do they do?
Do they work together?
What is their literacy level?
How many will there be? (approximately)
When will you conduct the training?
What day of the week?
What time of day?
What time of the year?
How long will the session be?
What will be the length of the entire program?
How much time is there for recruitment?
Where will you conduct the training?
What is needed?
What size room is needed?
What equipment is available?
What other supplies are needed?
Location
Is the location accessible?
Is the location easy to find?
Can it be reached by public transportation?
Is there safe parking?
Is it handicap accessible?
Is it a place that does not have negative connotations for
intended participants (e.g., some places are associated with
poor service or indigent care, which may make some participants
uncomfortable)?
What will the training involve?
What will be the content of the training plan?
What training tools will be needed?
What participant materials and resources will be
needed?
Will there be advance work for participants?
What is the purpose of the training?
What changes in knowledge, attitudes, behaviors,
and skills are you hoping to accomplish through the training?
What are the goals and objectives of the training?
How will you do it?
How will you enroll people for the training? Some
possible recruitment strategies include: flyers; PSAs on TV and
radio; ads in newspapers and newsletters; and word of mouth.
How will you engage participants?
How will you get feedback or evaluate the effectiveness of
your training?
Once these questions have been answered, the training goals and
objectives can be developed. The following section provides
definitions and examples of goals and objectives.
Setting Goals and Objectives
Goals
Goals are broad, general statements of what one hopes to
accomplish as a result of the training. An example of a goal might
be:
"Increased awareness of the importance of cancer clinical
trials."
Objectives
Objectives should describe the hoped-for changes in knowledge,
attitudes, skills, or behaviors in very precise terms. Usually they
are written in the following manner:
"By the end of this training (session), participants
will be able to __________________________."
The word that follows 'to' should be an action verb.
For objectives to be helpful in determining training
effectiveness, they should be measurable (e.g., "list five common
myths about mammography" or "compare three ways that barriers
to cervical and breast cancer screening are similar"). Attainment
of training goals and objectives is one important aspect of the
evaluation. Not all objectives are easily measured but most can be
evaluated using standard evaluation tools or other creative
strategies.
There are seven types of objectives:
Depending on what you hope to accomplish through the training,
some or all of these types of objectives need to be developed.
Keep in mind the adult learning cycle described in section I.2
when developing your training objectives. Fact, understanding,
attitudinal, and skill objectives might pertain to the
"experiencing" part of the cycle; analysis and synthesis might
pertain to the "processing" and "generalizing" parts of
the cycle; and application objectives might pertain to the
"applying" stage. Remember to move participants around the
adult learning cycle at least one time per module and design
objectives accordingly.
When writing the seven different types of objectives, the trainer
might find the following chart of verbs helpful.
Seven Objective
Training Types
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1. Fact objectives:
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2. Understanding or comprehension objectives:
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Identify
Translate
Restate
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3. Application objectives:
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Compute
Demonstrate
Illustrate
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Operate
Perform
Interpret
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4. Analysis objectives:
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Distinguish
Contrast
Classify
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Differentiate
Categorize
Critique
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5. Synthesis objectives:
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Synthesize
Design
Summarize
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Propose
Hypothesize
Formulate
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6. Attitudinal objectives:
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Show sensitivity
Respect opinions
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Accept responsibility
Demonstrate commitment
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7. Skill objectives:
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Perform
Demonstrate
Show
Conduct
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Compute
Teach
Role play
Take
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Operate
Complete
Design
Do
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Some examples of learning objectives that trainers expect
participants to achieve are listed below:
Seven Learning
Objective Types
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Fact objective:
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By the end of this training, participants will be able
to: List four risk factors for skin cancer.
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Understanding objective:
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By the end of this training, participants will be able
to: Describe three ways parents can protect their
children from the harmful effects of UV radiation.
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Application objective:
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By the end of this training, participants will be able
to: Demonstrate their ability to use NCI's Physician
Data Query to research information on cancer clinical trials
related to two case studies.
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Analysis objective:
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By the end of this training, participants will be able
to: Contrast the barriers to fecal occult blood testing
and colonoscopy by naming two barriers that are similar and
two barriers that are different.
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Synthesis objective:
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By the end of this training, participants will be able
to: Design an action plan to increase community
awareness of the importance of cancer clinical trials
through working within their own community-based
organizations.
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Attitudinal objective:
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By the end of this training, participants will be able
to: Demonstrate a commitment to increasing the number of
women aged 50 years or older who get mammograms by agreeing
to tell five friends in the next 3 months to schedule a
mammogram.
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Skill objective:
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By the end of this training, participants will be able
to:Perform a correct clinical breast exam using the
vertical strip method by demonstrating this to the trainer
during a simulation exercise with two standardized
patients.
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Suggested Methods for Creating Behavior Changes through
Training
To help people gain new awareness and information that will
translate into changes in attitudes and behavior, you must choose
training methods that correspond to the changes you hope to
accomplish. A variety of training strategies will ensure that the
learning needs of all types of participants are met. The list below
provides some suggested training methods for accomplishing changes in
each of these domains. A description of some of the more common
training methods, their advantages and disadvantages, and how to
implement them follows the list.
Knowledge (Concepts, Facts)
Attitude (Feelings, Opinions)
Behavioral Skills
Training Methods Overview
The following table summarizes which of the training methods
described below can be used to achieve changes in participants'
knowledge, attitudes, and behavior skills.
Training
Method
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Knowledge
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Attitude
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Behavior
Skilll
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1. Lecture
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X
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spacer
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2. Small Group Discussion
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X
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X
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spacer
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3. Brainstorming
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X
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X
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spacer
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4. Case Study
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X
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X
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X
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5. Demonstration
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X
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spacer
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X
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6. Role Play
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X
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X
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X
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7. Creative Work
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X
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X
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spacer
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Note: For tips on how to facilitate an entire training, see
Facilitating the Training Experience.
Training Method #1: Presentation/Lecture/Panel
Discussions
A presentation or lecture can convey information, theories, or
principles quickly and easily. Some examples specific to cancer
education might be reviewing the epidemiology of a specific type of
cancer or reviewing a current screening protocol. Presentations can
range from straight lecture to some involvement of the participants
through questions and discussion. Presentations depend on the trainer
for content more than any other training technique does.
Uses
Introduces participants to a new subject
Provides an overview or a synthesis
Conveys facts or statistics
Addresses a large group
Advantages
Covers a lot of material in a short time
Works with large groups
Provides context for more practical or hands-on training
techniques
Gives lecturer or presenter more control than in other
training situations
Disadvantages
Emphasizes one-way communication
Is not experiential in approach
Requires that participants take passive role in their
learning
Requires that lecturer possess skills as an effective
presenter
Is not appropriate for changing behavior or for learning
skills
Limits participant retention unless it is followed up with
a more practical technique
Process
Introduce the topic: Tell the participants what you
are going to tell them.
Use an opening that:
Explains the purpose of the presentation and
why it is important
Relates to the topic, situation, participants, or
speaker
Involves and stimulates the audience
Creates positive thinking and peaks interest
Gets attention, for example, by using:
Serves as a preview to subject matter
Present the topic
Hold participant attention and interest by:
Being enthusiastic, dramatic, or humorous
Using specific examples that:
Provide clarity, color, and credibility
Help a general thought become a specific one
Make the impersonal become more personal
Avoiding jargon
Varying the pace
Providing opportunities for participant involvement,
by:
Questioning both ways
Acknowledging individuals, by name, if possible
Asking for participant assistance
Using references that show material is aimed at a
specific group
Using surprises and extras
Inviting the participants to ask questions
Use a closing that:
Summarizes the entire activity and emphasizes
the key "take home" message
Makes a meaningful statement
Relates to the topic, situation, participants, or
speaker
Ties together the activity as an entity
Variations
A lecturette is a term used for a brief (e.g., no more than 15-20
minutes) presentation or lecture. Often these are made more
interactive by using a "call and response" format such as
interspersing questions to the participants in between lecture points
made by the presenter. For example the trainer might ask, "Which
communities or populations are most impacted by cervical cancer?"
After participants offer answers, the trainer could then validate the
right answers, correct misinformation or wrong answers, and then
briefly summarize the take-home messages. In this manner,
participants are acknowledged for what they already know while new
and accurate information can be offered by the trainer.
Another variation on the presentation method is a panel
discussion. A group of experts (e.g., cancer survivors, family
members, or health professionals) present their perspectives to the
participants through prepared remarks or spontaneous answers to
questions posed by a moderator or facilitator. This approach can be
made more interactive by allowing time for participants to ask
questions or make comments. A moderator or trainer can model this
interaction by asking one or two questions to "prime the pump."
Participants can also write their questions on index cards if the
size of the training group makes it logistically difficult for
participants to ask questions verbally.
Training Method #2: Small Group Discussion
A small group discussion is an activity that allows participants
to share their experiences and ideas or to solve a problem. It
exposes participants to a variety of perspectives and experiences as
they work together to accomplish the task. Some examples specific to
cancer education include breaking people into small groups to discuss
ways to encourage more people over the age of 50 to have regular
colorectal screenings or, for a health care professional audience,
ways to improve cancer pain management.
Uses
Enables participants to present their ideas in a
small group
Enhances problem-solving skills
Helps participants learn from each other
Gives participants a greater sense of responsibility in the
learning process
Promotes teamwork
Clarifies personal values
Advantages
Allows participants to develop greater control
over their learning
Encourages participants to be less dependent on the
trainer
Encourages shy or less talkative participants to become
involved
Allows for reinforcement and clarification of the lesson
through discussion
Builds group cohesion
Elicits information from participants
Disadvantages
Process
Arrange the participants in small groups using some of
the ideas listed on page 30
Introduce the task that describes what should be discussed
in the small group
Tell participants how much time they have
Ask each small group to designate:
Check to make sure that each group understands the task
Give groups time to discuss
Circulate among the small groups to:
Clarify any questions participants may have
Make sure that participants are on task
Make sure that a few participants are not dominating the
discussion
Bring all of the small groups together to have a large group
discussion
Have the people designated by each group present a summary
of their group's findings (this could be a solution to a problem,
answers to a question, or a summary of the ideas that came out
during the discussion)
Identify common themes that were apparent in the groups'
presentations
Ask the participants what they have learned from the
exercise
Ask them how they might use what they have learned
Determining Group Size
Participants learn through their own experience, especially by
discussing questions posed by the trainer. Discussions can take place
in a large group, in a small group, or between two participants. The
following information is useful in determining the appropriate size
of the group for specific activities.
Most people find it difficult to speak in a group of
strangers. Also, there is usually not enough time for everyone to
speak. Therefore, if everyone is to participate actively, small
groups are essential.
Most people find it difficult to listen attentively for
long periods. Therefore, talks should be short, and people should be
given an opportunity to discuss a topic or issue in small groups.
We all remember much better what we have discovered and
said ourselves than what others have told us. Therefore, participants
should be given questions leading them to express all they have
learned from their own experience first. This needs to be done in
small groups.
A resource person or facilitator can briefly sum up the
points from each group and add his or her own insights later, instead
of taking a long time to tell people what they know.
Pairs are useful for:
Interviews
Intimate sharing
Practicing some skills (e.g., listening or feedback)
A quick "buzz" with one's neighbor to stir a passion or prompt a
sleepy group into action
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For example, if your group consists of breast cancer
survivors, participants can pair up to discuss how they felt
when they were first diagnosed with breast cancer and
strategies they used to cope with their diagnosis.
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If your group consists of health care professionals, they
may pair up to discuss how they feel when they have to
notify a woman that she has breast cancer and strategies
they use to deal with being the bearer of such devastating
news.
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Triads (groups of three) are very useful for:
Getting everyone to think and participate actively; one
can be passive in a group of five, but that is unlikely in a group
of three
Testing out an idea one is hesitant to present to the full group
Groups of four, five, or six will add a bit more variety
for sharing ideas and insights. Four, five, or six can be a good size
for a planning team, a film discussion group, or a more complex
situation.
However, the bigger the group becomes, the longer the discussion
and the decision-making process.
Dividing Groups and Assigning Roles
When facilitating an interactive training, it sometimes is
necessary to divide participants into groups and assign them roles.
The following are some imaginative ways to divide participants into
groups:
Deck of cards-the four suits are the four groups
Colored stickers or dots placed on or under chairs
Different types of candy (e.g., peppermints, butterscotch,
cinnamon, or fruit flavors), which participants pick out of a
basket
M&Ms of different colors
If groups do not need to be exactly even, use things like
types of cars participants drive, types of toothpaste they use,
preferences for different types of music, etc.
Selecting a Group Recorder/Reporter
Select any date at random; the person whose birthday is
closest to that date becomes the recorder
Choose a person who lives closest (or farthest) from the
meeting site
Choose the person newest (or oldest) to the organization
Choose the person with the most pets (including fish)
Choose the person who exercises the most
Choose the person who watched the least TV in the past
week
Training Method #3: Brainstorming
Brainstorming is an activity that generates a list of ideas,
thoughts, or alternative solutions around a particular theme or
topic. Creative thinking is more important during this activity than
practical thinking. No idea is dismissed or criticized; anything
offered is written down. Often participants stimulate each other's
thinking.
After the list of ideas is completed, the group clarifies,
categorizes, or discusses one item at a time, depending on the
situation. Some examples related to cancer education include
brainstorming all the reasons teens start using tobacco or all the
barriers to referrals for clinical trial participation on the part of
primary care physicians in rural areas.
Uses
Introduces a problem or question (e.g., "Let's
brainstorm all the reasons women might be reluctant to return for
followup after an abnormal pap result.")
Forms the basis of discussion
Can use in conjunction with group discussion
Advantages
Generates ideas and leads to discussion
quickly
Allows everyone's ideas to be expressed and validated
without judgment
Generates energy to move forward with problem solving
Stimulates thought and creativity
Disadvantages
Can be difficult to get participants to follow the
rules of not diminishing or criticizing the ideas generated during
the actual brainstorming activity
Affords opportunity for participants to get off track and
develop a list too broad to guide discussion
Opens up the possibility that participants may feel badly
if their idea meets with criticism
Requires that participants have some background related to
the topic
Process
Establish the rules for brainstorming, including the
following:
All ideas will be accepted for the list
At no time should an idea be discussed or criticized
Discussion occurs only after the brainstorming session
is complete
Warm up the group by doing a "practice" exercise such as
having everyone write down on a piece of scrap paper everything
you can do with a rule-then go around the room and generate a
group list
Announce the cancer-related topic, problem, or question
Write the ideas and suggestions on a flipchart to prevent
repetition and keep participants focused on the topic
Note: It is helpful for your co-trainer to record the
ideas while you call forth the ideas from the group. If
there is no co-trainer, a trusted participant can function
in this role. Be sure, however, that the participant chosen
for this recorder role can keep up with a fast-paced
generation of ideas. Nothing impedes the brain-storming
process more than a recorder who constantly asks for ideas
to be repeated, words to be spelled, or acronyms to be
explained.
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Allow silence; give participants time to think
Provide positive feedback to encourage more input from participants (i.e.,
say "These are great ideas...")
Review written ideas and suggestions periodically to stimulate additional ideas
Conclude brainstorming when no one has any more ideas to add to the list
Review the final list before discussion
Variation
A variation to the method described above is to ask each participant to write down
his or her thoughts or ideas about the topic on Post-it notes. The trainer then collects all
the notes and quickly organizes the categories and responses under each one and discusses
the similarities, differences, consistencies, inconsistencies, and take-home messages.
Training Method #4: Case Study
A case study is a written description of a hypothetical situation
that is used for analysis and discussion. It is a detailed account of
a real or hypothetical occurrence (or series of related events
involving a problem) that participants might encounter. It is
analyzed and discussed, and participants are often asked to arrive at
a plan of action to solve the problem. Case studies can help group
members learn to develop various alternative solutions to a problem
and may help develop analytical and problem solving skills. Some
cancer-related examples are illustrated below.
Uses
Synthesizes training material
Provides opportunity to discuss common problems in a
typical situation
Provides a safe opportunity for developing problem solving
skills
Promotes group discussion and group problem solving
Advantages
Allows participants to relate to the situation
Involves an element of mystery
Avoids personal risks by using hypothetical situations
Involves participants in an active manner
Disadvantages
Process
Introduce the case study to participants
Give participants time to familiarize themselves with the
case
Present questions for discussion or the problem to be
solved
Emphasize that there is not always only one right solution,
if appropriate for the specific case
Give participants time to solve the problems individually or
in small groups
Circulate among the small groups to:
Clarify any questions participants may have
Make sure that participants are on task
Make sure that a few participants are not dominating
the discussion
Bring everyone back together for a larger group
discussion
Invite participants to present their solutions or
answers
Discuss all possible solutions or answers
Ask the participants what they have learned from the
exercise
Ask them how the case might be relevant to their own
lives
Summarize the points made
Tips for Developing Case Studies
Develop a case study that is as realistic as
possible.
Describe the people in the case study.
Use names (but be sure to indicate that they are not the
names of real people).
State their genders, ages, ethnicities, and other relevant
characteristics.
Describe the specific situation.
Think about the specific issues you want the participants
to address.
Use the case study to challenge assumptions (e.g., health
care worker doesn't always know the answers, patients aren't
always uninformed).
Avoid giving solutions to the problems raised in the case
study.
Avoid making the case study too complex or too simplistic.
Some examples of discussion questions that use the adult learning
cycle as a model include the following:
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Describe what you see and hear happening in this
case study.
What feelings does the case study evoke in you?
What are the key issues that are brought to light by
this case study?
What do you think are some of the underlying causes
that lead to these issues?
What are some possible strategies for dealing with
these issues?
How can we each make a difference in addressing these
issues?
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Example Case Study
You have been invited to conduct a training for home health nurses
on the topic of cancer pain management. You were told that there are
a number of issues that impede the use of appropriate pain medication
with cancer patients who are followed by the home health agency. One
of these in particular involves nurses not feeling comfortable
advocating with physicians for their patients because of fear of
addiction to opiate derivatives.
During the training, a nurse participant, Suzanne, brings up a
recent article she read in the New York Times Magazine. The article
described the abuse of oxycontin in rural America. Suzanne says,
"There's no way I'm going to contribute to getting a whole generation
hooked on those things. I'm just trying to protect my patients'
grandkids by keeping those things (oxycontin pills) out of the
house." Another participant, Ellen, adds that most of her "little old
ladies" are too sensitive to medications to "get them started on
something that powerful." You realize that there are a lot of
passionate feelings about this topic and wonder how you should handle
the situation.
Case study questions for training participants to discuss:
Describe what you see happening in this case study.
What feelings does the case study evoke in you?
How do you think Suzanne is feeling?
How do you think Ellen is feeling?
What do you think are the underlying issues behind each of
their responses?
What are some effective ways you, as the trainer, could handle
this discussion?
How will your discussion about this case study influence how
you might handle other difficult training discussions in the
future?
Training Method #5: Demonstration
A demonstration is a method for showing precisely how a skill,
task, or technique should be done. The trainer or a skilled
participant shows other participants how to successfully perform a
given task by demonstrating it, describing each step, and explaining
the reasons for performing it in a particular way. It is often
followed by a practice session in which the participants carry out
the activity under the supervision of the trainer. The use of models
or props (e.g., silicone breast models or fecal occult blood
collection kits) greatly enhances a training on self breast exams or
colorectal screening. Having simulated or standardized patients for
clinicians to practice new skills (e.g., performing clinical breast
or pelvic exams) leads to effective acquisition of these new
skills.
Uses
Show participants how to perform a skill (e.g.,
showing community members how to do a self breast exam or use the
collection kit for a fecal occult blood test)
Clarifies and corrects misconceptions about how to perform
a task
Shows how participants can improve or develop skills
Models a step-by-step approach (e.g., how to do a clinical
breast exam using the vertical strip method)
Advantages
Provides learning experience based on actual
performance and is relevant to the participant's job or personal
experience, especially when combined with hands-on practice
Illustrates processes, ideas, and relationships in a clear
and direct manner
Requires low development costs
Helps participants' focus their attention
Involves participants when they try the method themselves
Disadvantages
Has limited usefulness
Requires a lot of planning and practice ahead of time
Requires facilities and seating arrangements that are
carefully planned so all members of the audience have an
unobstructed view of the demonstration
Requires enough materials for everyone to try the skill
being demonstrated
Does not ensure that participants will immediately be able
to duplicate the skill being demonstrated after seeing it
demonstrated
Requires that participants take passive role during
demonstrations which may cause them to lose interest, particularly
during afternoon hours and toward the end of the session
Process
Introduce the skill being demonstrated: What is the
purpose?
Present the materials that are going to be use
Demonstrate the skill for participants
Repeat the demonstration, explaining each step in detail
Invite the participants to ask questions
Allow participants to practice the skill themselves
Circulate around to each person to:
Bring participants back to the larger group
Discuss how easy or difficult it was for them to perform the
skill
Summarize the take-home messages or key points
Training Method #6: Role Play
Role play is a technique in which several individuals or a small
group of participants act out a real-life situation in front of the
group. The scenario of the role play is related to the training topic
and must have a skill-based objective. For example, in a training on
breast cancer for nursing students, two participants might role play
how to teach a woman how to do a self breast exam. There is no
script; however, the situation is described in as much detail as
appropriate. The participants make up their parts as the situation
unfolds. The role play is then discussed in relation to the situation
or problem under consideration.
Uses
Helps change people's attitudes
Enables people to see the consequences of their actions
Provides examples of possible reactions or behaviors
Provides a safe environment for exploring problems they may
feel uncomfortable discussing in real life
Enables participants to explore alternative approaches to
various situations
Explores possible solutions to emotion-laden problems
Advantages
Provides opportunity for stimulating new ideas
while having fun
Engages the group's attention
Simulates the real world
Provides a dramatic way of presenting a problem and
stimulating a discussion
Allows participants to assume the personality of another
human being-to think and act as another might
Disadvantages
Requires that participants feel comfortable being
in front of a group (some participants may feel self-conscious,
shy, or may fear looking "ridiculous")
Requires dyads or triads in which everyone is either acting
or observing to address participant reluctance
Process
Prepare the actors so they understand their roles and
the situation
Set the climate so the observers know what the situation
involves
Observe the role play
Thank the actors and ask them how they feel about the role
play (be sure that they get out of their roles and back to their
real selves)
Share the reactions and observations of the observers
Establish ground rules for having a group discussion about
the role play. For example:
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Make your comments in a self-oriented manner.
Try to express your feelings as you were watching the
role play. For example, "The interaction in the role
play made me feel
"
Make your comments descriptive of what happened.
For example, "I noticed that the woman had eye contact
twice with her friend."
Try not to interpret the behavior of the players
in terms of why they did what they did. If this seems
necessary, however, ask the players in an open-ended way
rather than putting words into their mouths (e.g., "I
was wondering why you asked the woman her marital
status.")
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As a group leader, your attitude and direction in this discussion are important. Try to protect
the role players from too much exposure to negative comments. In addition, try to get the observers to put their comments in the form of suggestions on how to improve the handling of the situation. The best way to do this is to set the example yourself. Attempt to be as nonevaluative as possible. Try to invite people to talk freely about their own experiences. Then summarize the comments given in relation to the learning points.
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Discuss as a group the different reactions to what happened
Ask the participants what they have learned
Ask the participants how the situation relates to their own situation
Summarize the main messages or points and application
Handling Participant Resistance
There might still be some resistance to role playing. Several
types of resistance you might encounter are presented below along
with suggestions on handling.
Fear of exposure: This usually relates to a
person's fear of being exposed to the total group and acting as a
fool. One way of handling this is to use multiple role playing rather
than single role playing. Divide the group in pairs and ask them to
do their own role plays in different corners of the room. Using this
method, you should walk around to get a feel for how each dyad is
doing and whether the role play is being used the way it was
intended.
What is going to happen to me? Generally this refers
to a person's fear of not knowing the procedures involved in role
playing. This may be related to lack of knowledge about the topic or
lack of role playing skill. Usually a good explanation of the
different steps in the session clarifies the issue. You should ensure
that people won't be criticized by acknowledging how difficult role
plays can be and thanking participants for their bravery in being
willing to step outside their comfort zone to provide an excellent
learning experience for everyone.
The most important thing in dealing with resistance seems to be to
allow it to be there, accepting the feelings and thoughts behind it.
But at the same time, you should try to be clear that you want to do
the role play and why. If you feel good about it, this will be
reflected by the group.
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Role Play Example: A Woman with Colon Cancer
Considering Clinical Trials
You are Sonya, a woman just diagnosed with
colon cancer. You have no medical insurance. You are
talking to Mary, the local support group leader, about
recommended treatment options. You've heard about
clinical trials, but you tell her, "I don't want to be a
guinea pig just because I'm poor."
You have heard about the Tuskegee study, in which
African American men with syphilis were studied for years
without getting treatment. You know that some of your
neighbors get paid for participating in asthma studies.
You want the best treatment, but you don't want to be
treated poorly.
You want to know:
What are clinical trials?
Why can't I choose my treatment if I decide to be
on a trial?
What are the pros and cons of participating?
Are they experimenting on people?
How do I know I'm being protected?
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You are Mary, a local community leader who runs
a support group. You want to assist Sonya by helping her
understand more about what clinical trials have to offer
and refer her to community resources. Talk with her using
the following guidelines:
Be sensitive to Sonya's concerns.
Remember to provide information that is
fact-based, not your opinion.
Provide resources and support.
During the discussion, you may wish to address the
following:
What clinical trials are
How patients are protected
Risks and benefits of participating
Informed consent
How to find out about clinical trials in the
community that might be appropriate
Talking about this information with her doctor or
nurse
Talking with her family
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Training Method #7: Creative Work
Although some people believe that using the arts in training is
"touchy feely" and therefore not appropriate, others have found that
this approach is well received by many audiences. These training
activities give participants an opportunity to think or act "outside
the box." Examples of creative activities include:
Making a collage (e.g., make a collage of ways you got
support when you were diagnosed with cervical cancer)
Drawing or painting with markers, water colors, chalk, or
colored pencils (e.g., painting a picture of what fear of recurrence
looks like)
Modeling with clay (e.g., making a sculpture of the body
post-mastectomy)
Composing songs, poems, stories, or plays (e.g., writing a
play about teens who changed their peer group's norms related to
smoking tobacco)
Uses
Encourages participants to engage the "right
brain" (creative, non-linear part), especially important after a
"left brain" training method (i.e., didactic or linear
presentation)
Explores other ways to think about familiar situations
Enables participants to explore emotionally-laden topics in
a safe way
Encourages people to move beyond their comfort zone
Advantages
Gives participants an opportunity to have fun
while dealing with emotionally laden issues
Allows participants to move around (especially good for
kinesthetic participants)
Provides a creative way of dealing with sensitive
issues
Fosters interaction and emotional connections among
participants
Disadvantages
Requires additional space and materials
Intimidates participants who feel shy about artistic
endeavors (But don't assume that your audience won't respond well
to this technique. You might try out the idea with a few people
who are demographically matched to your potential participants
before your training session.)
Causes participants who are used to linear thinking and
came to the training to get new information to question the
usefulness of this approach
Process
Introduce the creative activity to participants
Discuss how the activity ties into the topics being
covered
Provide participants the "permission" to take risks, be
creative, and not feel that they have to strive for perfection.
Sometimes asking people to remember what they were like in the 5th
grade will help them to be less inhibited and "let go" of their
inner critic
Assure participants that these activities are not intended
to be judged on artistic merit but rather to stimulate new ways of
thinking about the topic
Review the materials that are available to complete the
creative activity (e.g., clay, markers, magazines, scissors, glue,
etc.)
Tell participants how long they will have to work on their
creations (e.g., minimum of 30 minutes). Explain that you will
give them a 10-minute warning before they have to finish their
work
Provide the allotted time for participants to create
Circulate around the room to see how participants are
doing
Give the 10-minute warning, as promised
Bring everyone back together for a larger group
discussion
Discuss the ground rules for the discussion:
Participants should support each other
Comments made about another person's creation should
relate to how the creation makes them feel
Comments should not be evaluative or judgmental
Invite individuals to share their creations and how they
tie into the topic
Ask participants to discuss both of the following:
Summarize the discussion
Affirm participant's work and ability to be creative
Audiovisual materials are essential to effective instruction.The
primary purposes of training media are to support the explanations
(by illustrating, demonstrating, and emphasizing) and to provide
motivation (by increasing sensory appeal, adding variety to the
instructional approach, saving time, and retaining participant
interest). They can be used to increase knowledge and change
attitudes.
Characteristics of Effective Training Media
They should be:
Simple (easy to understand, uncomplicated)
Accurate (facts and figures, current information)
Manageable (easy to operate and manipulate, simple, neat,
and practical)
Colorful (use color to emphasize main points)
Necessary (illustrate essential materials, contribute to
successful accomplishment of learning objectives)
When Selecting Training Media
Use your training objectives to determine where
audiovisual materials are needed to assist participant
learning.
Be selective. Remember that a few good training media will
do more for the achievement of objectives than will many confusing
ones.
Update and improve your use of training media or develop
new ones for more effective participant learning.
Consider the enhanced visual/verbal relationship that
different media can create. The objective is to maintain visual
simplicity and verbal clarity for maximum retention of
information.
Remember that dark rooms can put participants to sleep
especially after a meal. Keep the area as well lit as possible
while ensuring participants can see the words on the screen.
Maximize the use of media by following slides, videos,
audiotapes, and photos with a targeted discussion. Consider the
following format as one useful way to move participants from
description, to feelings, insights, and action steps:
Describe what you see and hear happening in this
video.
What feelings does the video evoke in you?
What are the key issues that are brought to light by this
video?
What do you think are some of the underlying causes that lead
to these issues?
What are some possible strategies for dealing with these
issues?
How can we each make a difference in addressing these issues?
Main Types of Training Media
Handouts
Handouts are supplementary materials that provide a detailed
expansion or reiteration of one or more aspects of the
presentation.
Hints:
Handouts can be your worst distraction during a
presentation if distributed while you are speaking. Whenever
possible, provide handouts at the end of a presentation unless the
audience will use them during the training. In that case, provide
the handouts before the presentation to avoid distraction.
Reduced-size reproductions of charts or slides used during
the presentation can be extremely useful to participants as
reference material. Adding brief interpretive statements can
remind participants of your key points at a later date.
Flipcharts
A flipchart pad can provide flexibility for
developing and modifying simple sketches, diagrams, and statements
during the course of a presentation.
Color is extremely important. Green, blue, and brown should
be used primarily for words. Avoid visuals that are one color. Use
red, orange, or yellow for highlighting only. If you have five- or
six-line visuals, use colors to separate them or to group them.
Hints:
Maintain the flow of your talk while you
write.
Avoid talking to the board.
Stay to the side while writing on a flipchart pad.
Write large and neatly.
Draw a faint outline of a diagram or model in pencil before
the presentation to provide guidelines for the marker or
chalk.
Limit the number of words to avoid pages that are too
"busy" and thus distracting.
If you prefer, have a co-trainer or participant write while
you facilitate group discussion.
Overhead Projector
An overhead projector is used to project material from a book or a
prepared transparency onto a screen.
Hints for designing transparencies:
Do not use more than four of five words per line.
Keep in mind that the area that can be projected is only 7.5" x
9.5".
Do not crowd too many lines onto a transparency.
Design it so it can be read from the back row of the
training room.
Use dark letters on light backgrounds.
Hints for using overhead projectors:
Place a transparency on the projector before the
training in order to focus it.
Always have a spare light bulb (in case the one provided
with the overhead projector burns out) and extension cord with
you.
Designate someone to control the room lights.
Slides, LCD Projectors, and Computers (for computer-generated
presentations)
Slides are still the most common visual aid used in training.
However, many health care professionals are switching to LCD
projectors and computers to project computerized presentations onto a
screen. The following information applies to both slides and
PowerPoint presentations.
Hints for designing slides or a computer-generated presentation
(e.g., PowerPoint):
Keep each screen simple with bullet points and
simple visuals. Each bullet point can be elaborated during the
presentation.
Use large enough font (30 point) so that the text can be
read from the back row of the training room.
Use colors and designs that are pleasant, but not
distracting for the viewer.
Use colors that make text stand out on a slide. Use a light
color for the text on a dark colored background (pale yellow on
dark blue is best). The more color used, the less effective it
will be.
Use visual aids that complement the text.
Use uniform font.
No more that 75 percent of each slide should have text.
Use animation (on PowerPoint presentations) sparingly.
While it is interesting to have bullet points appear or cross the
screen as you read them, too much animation can be distracting.
Hints for using slides:
Make sure your slides are placed in the carousel
so they project right side up.
Practice showing your slides before the training.
Practice using the remote control for changing slides.
Practice operating the electronic pointer if you will be
using one during your presentation.
Always have a spare bulb and an extension cord with
you.
Designate someone to control the room lights.
Hints for using an LCD projector and computer:
If you do not have your own slide projector or LCD
and portable computer, reserve one for your training.
Make sure the computer is equipped with compatible software
to run your presentation (e.g., does the computer have
PowerPoint?).
Make sure that your presentation fits onto a diskette, or
put it on a Zip Disk. If a Zip Disk is needed, you will need a
portable Zip Drive.
Before the training, do a test run of your presentation to
assure that there are no problems using your disk in the
computer.
ALWAYS BRING A COPY OF YOUR PRESENTATION ON
OVERHEADS-JUST IN CASE!
Examples
Examples of good and bad slides from computer presentations
follow:
Bad Example
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Ways to
Prevent Skin Cancer
|
Stay out of the sun between 10:00 a.m. and
4:00 p.m. unless you are adequately protected.
Wear sunscreen that is 15 SPF or higher. Make
sure that the sunscreen has not expired. Reapply
sunscreen several times thoughout the day.
Be sure to wear long-sleeved shirts, long pants,
wide-brimmed hats, and sunglasses.
Talk with your friends and family members about
sun protection. Remind them to stay away from the
midday sun, use sunscreen, and wear full coverage
clothing.
It is best to combine these strategies to make
sure that you are getting full prevention from the
sun and decrease your chances of developing skin
cancer.
|
|
Good Example
|
ABCs of
Decreasing Skin Cancer Risk
|
Away-Stay away from the midday sun
Block-Use 15 SPF or higher sun block
Cover-up-Wear full coverage clothing
Use a combination of these strategies
|
|
Videotape Players
Because the videotape player is extremely versatile, it is rapidly
becoming a major tool in presentations.
Hints for using videotape players:
Use is limited for large groups (i.e., more than
20 participants) because multiple monitors or large video
projection screens are needed.
Most equipment is portable but cumbersome.
Compatibility of the type and size of the videotape and
cassette to the available equipment should be carefully
considered.
Have tapes set at the proper starting point so that only
the PLAY button needs to be pushed.
Once you are clear about the characteristics of the participants
and the training goals and objectives, you can design a realistic and
effective training plan.
It is important to consider not only what you hope to achieve in
terms of changes in knowledge, attitudes, and skills, but also the
sequence of various training activities and information. There should
be a good balance between didactic and interactive activities,
between acquiring new knowledge and skills, and having an opportunity
to synthesize and apply new information and behaviors. Most trainers
design trainings that are too packed with activities and information.
While it is important to have additional activities that can be used
if needed, it is essential to remember that participants will retain
more if given opportunities to reflect, synthesize, and practice new
insights and skills. Some guidelines to follow include the
following:
Vary Activities
Change the type of activity approximately every 30 minutes (e.g.,
if you just gave a 20-minute lecturette on a new cervical cancer
screening policy, give participants an opportunity to discuss in
small groups the implications of this policy on their client base or
have participants apply this new information to a prepared case
study).
|
Intersperse didactic activities such as lecturing
and demonstrations with more participatory ones such as
small group exercises, individual work, role plays, and a
variety of other training strategies.
Vary learning activities to appeal to all types of
participants.
Structure activities to go from simple
to complex concepts; from safe to more
risk-taking activities.
Include activities that encourage real-life problem
solving.
Include opportunities for application and
practice.
|
Set Realistic Goals for the Training
Choose information or skills that participants
need to know; not information that would be nice to know.
Think about your learning objectives (developed in section
II.1 and develop your take-home messages to correspond with
them.
Remember that three to five take-home messages are the most
people can retain in a one-day training.
Match objectives to training and evaluation methods. For
example, didactic or lecture methods can lead to knowledge change
but probably not attitude change or skill acquisition. Interactive
methods can lead to change in knowledge and attitudes.
Demonstrations and practice can reinforce skill acquisition.
Think about how you will evaluate the training.
Be Aware of Time Management Issues
Build in time for movement from one activity to
another. This is especially important if small group breakouts
take place in a different room from the main meeting room.
Build in time for forming small groups.
Build in some "slush" time to make up for a late start,
getting behind schedule because of lengthy discussion, dealing
with unforeseen circumstances (e.g., fire drill), or other time
challenges.
Build in time for breaks. Give participants a break no less
frequently than every 90 minutes.
Prepare a Clear Training Plan
The level of detail with which a training plan is written depends
on a number of factors:
Whether you or another person will be conducting the training, it
is extremely important that all directions for activities be
explicitly written as well as examples of questions to be used to
process or discuss the activities. The suggested time allotment for
each activity should also be clearly stated as well as the materials
needed to conduct all the activities. This level of detail will
ultimately make your life easier and will ensure a smoother training
program.
A "Sample Training Plan Template" and a "Training Plan Worksheet"
are located in appendix B. A sample training plan follows on the next
few pages. For this sample,
The left column contains:
Plenty of blank space so you can jot down your own
notes
A list of training materials that are needed for each
portion of the training
An estimate of how much time it will take to complete
each portion of the training
|
The right column contains:
Detailed instructions for what to do and say
Description of how to use any training materials that
are needed for each portion of the training
Lists of possible answers to questions posed to
participants during the training session
Text in italics indicates things for the trainer to
say to participants
|
Sample Training Plan
Time and
materials
|
Task
|
Trainer
instructions
|
60 minutes
|
Set up room and familiarize self with location
|
Arrive early to set up the room.
Make sure there are enough chairs and that they are arranged
in a circle (around a table) to facilitate participation
anddiscussion.
Organize handouts, training materials, and visuals (e.g.,
breast models, mammography films).
Locate lights.
Set up and test audiovisual equipment.
Put out refreshments, candies, etc.
Put out a sign-in sheet and name tags.
Make the room more comfortable and enjoyable (tablecloths,
decorations, music, etc.).
Locate restrooms, telephones, and water fountains.
|
10 minutes
Sign-in
sheet
Drinks and refreshments
|
Participant arrival and sign-in
|
As participants arrive:
Ask participants to write their names on sign-in sheet.
Ask participants to write their names on a name tag.
Offer drinks and light refreshments.
Welcome participants and thank them for taking time to
participate in this training.
Reassure them that we are going to have fun while we learn
about breast cancer early detection measures.
Review "housekeeping" details such as the location of
restrooms, telephones, and water fountains.
|
Time and
materials
|
Task
|
Trainer
instructions
|
5 minutes
Prepared
flipchart - Agenda
Prepared flipchart - Goal and objectives of training
|
Welcome and introduction
|
Welcome and make brief introductions.
Refer to flipchart with agenda. Explain that we have a lot
to cover, but hopefully it will be interesting and
engaging.
Refer to flipchart with goal and objectives of the training.
Explain that the goal of this training is to:
Explain that the objectives of this training. By the end of
this training participants will be able to:
Demonstrate steps involved with making an
appointment for a mammogram
List at least three barriers women may face to
obtaining a mammogram and suggestions on how these barriers
can be addressed by health care organizations.
Describe American Cancer Society recommendations
for mammography screening.
Demonstrate commitment to increasing awareness
about the need for mammography screening by telling at least
four friends to schedule a mammogram in the next month.
|
15 minutes
|
Icebreaker
|
Explain
that we will be doing a lot of work together today so it's
important to know a little about each other.
Give instructions for the icebreaker:
In a roundtable format, ask participants to say
their name, what they know about why they were given their
name (e.g., named after great aunt), or what it means (e.g.,
the name Athena is the Greek word for "light").
Ask the women if they think their name fits their
personality.
|
5 minutes
Prepared flipchart - Norms
|
Group discussion and group norms
(this will be covered in more detail in section III. 1.)
|
Explain to participants that setting "norms" or ground rules
for the training will help make the training a safe,
respectful, and comfortable environment for everyone to
learn and share.
Refer to flipchart with norms listed on it. Review each norm
and give a brief explanation.
Ask if anyone has additional ground rules to add.
Post the ground rules on the wall to serve as a visual
reminder.
|
15 minutes
Blank flipchart paper
Colored markers
|
Group brainstorm: barriers women may face to obtaining a
mammogram
|
Explain to participants that studies have shown that many
women face several barriers to obtaining a mammogram.
Ask the participants to brainstorm a list of barriers women
may face.
Review the rules of brainstorming with participants. That
is, that during the actual brainstorming of ideas, nobody
should criticize any ideas that others suggest. Ideas will
be discussed only after the brainstorming session is
completed.
Using a blank flipchart paper, write down the barriers
participants suggest.
|
Time and
materials
|
Task
|
Trainer
instructions
|
15 minutes
Blank flipchart paper
Colored markers
|
Group brainstorm: barriers women may face to obtaining
a mammogram (continued)
|
Some examples of barriers women may face include:
Lack of insurance to cover mammogram
Lack of transportation to the appointment
Lack of childcare during the appointment
Difficulty in taking time off work for appointment
Embarrassed to disrobe in front of the
provider
Fear that the mammogram will hurt
Fear of finding breast cancer
Fear that having a mammogram means that the woman
has no faith in God
When the participants are finished brainstorming the list of
barriers, add the barriers that may have been missed.
Read through the list out loud, getting rid of duplicate
answers or grouping similar types of barriers suggested.
Explain that in the next portion of the training,
participants will work in small groups to discuss ways that
health care organizations can address these barriers so that
more women will be able to obtain mammography screening.
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