An integrated knowledge translation project to develop, implement, and evaluate a train-the-trainer program at a community rehabilitation program in Tamil Nadu, India

Abstract

Purpose

This project aimed to develop, implement and evaluate a train-the-trainer initiative for community rehabilitation workers (CRWs) and rehabilitation specialists within a community rehabilitation program for children with delayed development in Tamil Nadu, India.

Methods

Guided by the Knowledge to Action framework, non-governmental and academic partners collaboratively developed two 2-day workshops for (1) rehabilitation specialists and (2) CRWs. Outcomes were evaluated using mixed methods, with pre and 2.5-months post surveys (59 participants) and three focus groups (17 participants) involving trainers and trainees (including rehabilitation specialists and CRWs).

Results

There were significant increases in the CRWs’ self-perception of their capacity to assess comprehension, provide explanations, respond to questions, adjust teaching, motivate learners, communicate effectively, and provide feedback. Significant changes were noted for rehabilitation specialists in five of seven domains, and for rehabilitation specialist leads in six of seven domains. Participants appreciated the interactive training style, and the use of immersive methods such as role play, though noted challenges when instructions were unclear or when they felt that material was more theoretical.

Conclusions

This collaboratively developed train-the-trainer project demonstrates the value of such an intervention, provides an example of how a tailored program can be developed, and suggests the importance of stakeholder-driven design processes.

Implications for Rehabilitation

• The ability to provide effective training is a core skill set for people engaged in community-based rehabilitation (CBR) programs, yet examples of initiatives to train trainers are lacking, as is their evaluation.

• This project demonstrates the value of a collaborative and tailored train-the-trainer program to support community rehabilitation workers and rehabilitation specialists in their training roles within a CBR program in India.

• A stakeholder-driven design process supported by a collaboration between non-governmental organization and academic partners enhanced the capacity to develop, implement and evaluate the train-the-trainer program.

Keywords:

• Community health services
• continuing education
• India
• knowledge translation
• rehabilitation
• training of trainers

Acknowledgements

The authors thank the participants who took part in the train-the-trainer program and its evaluation, as well as Sivahahmy Vijayaratnam for facilitating, translating, and transcribing the focus group discussions, and to the ASSA leadership for their support of this project. An earlier version of this paper was presented at a symposium on capacity building and education in global health rehabilitation which took place at McGill University on 4 June 2019.

Additional information

Funding

This project was funded by a grant from the Richard and Edith Strauss Canada Foundation. Matthew Hunt and Aliki Thomas are supported by Research Scholar Awards from the Fonds de recherche du Québec – Santé.