Pakistan On-the-Job Training

After identifying what family planning topics your training program will cover, determine what type of on-the-job training works best for the providers in your setting:

• In-service training: The goal of on-the-job in-service training for family planning is to offer practical learning experiences for providers in their own work environment as opposed to using models in a classroom setting. In-service training also provides a monitoring and evaluation perspective to the coaches/program team as to conduct simultaneous quality checks, while disseminating training and hands-on skills.
• In-reaches: Learning is not limited to a classroom or on-job training. A learning exchange program where master trainers  can visit the service provider’s clinic(s) or a service delivery point to guide and mentor her/them, while providing services to the clients. Often focusing on provision of LARCs and/or permanent methods, the master trainers works side-by-side with your team, providing your providers with hands-on experience and enabling them to eventually provide these methods without the assistance of the visiting team.
• On-site mentoring: A highly experienced health care provider guides improvement in the quality of care delivered by other providers and the health care systems in which they work through a sustained collaborative relationship. Such mentoring offers opportunity for learning-by-doing, real-time practice and feedback. The mentors will need training of their own to standardize their knowledge and skills, ensure their clinical skills are up-to-date and that they are familiar with the latest policy updates and mitigate any signs of provider bias. Sometimes, the term “supportive supervision” is used to mean on-site mentoring.
• Refresher training: Refresher training ensures that knowledge and skills obtained in a comprehensive training session are continually being strengthened and that information is not lost after the official training. Refresher trainings can take place in-person through formal training and/or TCI coaching sessions. Continuous Medical Education (CMEs) can also be used as refresher sessions, specially organized on hook days such as World Health Day or International Women’s Day.
• eLearning for continuous learning and professional development: Greenstar Social Marketing recently launched an online portal “Provider Portal”, that is a subscription-based eLearning platform for service providers to access videos, literature and recorded sessions at their convenience.

These different approaches can be combined to suit your needs. For example, you may want to have an in-reach to train your providers on IUD insertion, followed by on-site mentoring to ensure providers are using the new skills properly. Or you may decide to deliver refresher training through an eLearning course.

• Based on the results of the TNA that you conducted in Step 1, you should determine the training schedule based on topics/skills that have been identified as gaps. Also, as part of the TNA, you should be able to identify individual with the necessary skills that can help with facilitating the trainings. You can use the existing pool of trainers or hire external trainers. Make sure you provide the trainers with sufficient supplies, such as LARC training models, contraceptive commodities, stationery and consumables, to facilitate their training. Where necessary, provide transportation support to help trainers reach the trainees (if at different facilities).
• Next, determine what methods, sources or materials you need to complete the trainings.

Now you are ready to implement the training activities. Make sure the training activities are as hands-on as possible, and that the trainees have the opportunity to observe experts, immediately practice what they learn and ask questions as they go along. You should give the trainees the opportunity to discuss their challenges with the trainer, as well as with each other, to maximize learning.

Once the training is complete, you must run a post-training assessment to assess providers’ knowledge, attitudes and performance. From this assessment, you can learn the impact of the training and the extent to which you need to provide ongoing support, including additional mentoring, supportive supervision and refresher trainings as needed.

Continually monitor and assess your on-the-job training program – the individual components such as on-site mentoring, refresher training or in-reaches as well as the overall training program as a whole. Are these training approaches working for your staff? Could they benefit from another training approach? Assess the capacity of staff to complete their work, the learning process of the staff and note any new gaps or challenges that emerge. Are they effectively implementing the learnings?