High quality training and mentorship of clinical staff in NCD care is critical to address gaps in current medical education curricula at institutions of learning in many resource-limited settings.
Tools for training and mentorship
Both didactic and practical training curriculua are essential prior to implementation at a new facility. Ideally, at least two clinicians per facility are trained as designated NCD leads.
Either nurses, clinical officers, or general practitioners will be leading the clinical care of NCD patients at district hospitals, depending on the setting. Given the limitations in human resources and staff turnover, especially for physicians, task shifting lead clinical responsibilities to mid-level providers, such as nurses and clinical officers, is oftentimes ideal.
The practical training facility should ideally be a model district hospital, which has successfully implemented an integrated NCD delivery program. If a strong, district-level NCD program does not yet exist, then an initial goal of the implementation team should be to establish such a facility.
NCD clinical training slide decks
The following teaching slides were produced by the Rwandan Ministry of Health and Inshuti Mu Buzima (IMB), Partners In Health’s sister site in Rwanda, and are designed for nurse-led care, but are easily applicable to other cadres of health practitioners.
The initial training of nurses in NCDs may include one month of didactic training followed by one month of practical training. The follow-up refresher trainings should focus on didactic sessions for one week every 6 months.
- Type 1 Diabetes for Providers - Set of 6 Presentations (zip.)
- Heart failure slide deck with facilitator notes (pptx.)
- ECHO cardiography slide deck with facilitator notes (pptx.)
- Chronic kidney disease slide deck with facilitator notes (pptx.)
- Insulin and non-insulin dependent diabetes slide deck with facilitator notes (pptx.)
- Chronic respiratory disease slide deck with facilitator notes (pptx.)
- Hypertension slide deck with facilitator notes (pptx.)
Mentorship and enhanced supervision of health care (MESH)
Decentralization of services to remote health centers may call into question a facility’s ability to deliver quality services. After the initial training, ongoing on-site mentorship is needed to ensure that quality care is delivered. The MESH model allows for measurable supervision of quality of care by health center clinicians. In this model, expert NCD clinicians at the district level are trained to become mentors to the clinician mentees at the health center. The following implementation guide provides more details and context surrounding the MESH model.
The following slide deck training materials, produced by PIH in collaboration with the International Training & Education Center on HIV (I-TECH) are designed to be used in the training of mentors over a three-day period.
- What is clinical mentoring? (pptx.)
- Building relationships (pptx.)
- Effective communication and feedback skills (pptx.)
- Theories of learning (pptx.)
- Clinical teaching skills (pptx.)
- Clinical diagnosis and decision making (pptx.)
- Addressing system issues (pptx.)
- Conducting effective mentoring visits (pptx.)
- Data interpretation (pptx.)