| Session Title: Accounting for Contextual Factors in the Evaluation of Continuing Medical Education Programs |
| Multipaper Session 704 to be held in Panzacola Section F3 on Saturday, Nov 14, 9:15 AM to 10:45 AM |
| Sponsored by the Health Evaluation TIG |
| Chair(s): |
| Kevin Khamarko, University of California San Francisco, kevin.khamarko@ucsf.edu |
| Abstract: The AIDS Education and Training Centers (AETCs) supports a network of 11 regional centers that conduct targeted, multi-disciplinary education and training programs for health care providers treating persons with HIV/AIDS. The mission of the AETCs is to improve the quality of life for patients living with HIV/AIDS through the provision of high quality continuing medical education and training. Up to now, the AETCs have utilized Donald Kirkpatrick's typology for measuring four aspects of training: participants' reactions to training; learning; behavior change; and ultimately, the results for patients of trained providers. Although these domains are useful for conceptualizing and carrying out evaluation, we have found that application of training material is complicated by aspects of the setting, organization and social context in which the content of the training is applied. This session will provide specific examples of how the AETCs are accounting for contextual factors in their current training evaluations. |
| Understanding the Barriers and Facilitators to Applying the Content of AIDS Education Training Centers (AETC) Trainings |
| Kevin Khamarko, University of California San Francisco, kevin.khamarko@ucsf.edu |
| Kimberly Koester, University of California San Francisco, kimberly.koester@ucsf.edu |
| Janet J Myers, University of California San Francisco, janet.myers@ucsf.edu |
| The AIDS Education and Training Centers' National Evaluation Center (AETC NEC) provides evaluation development and technical support to the national AETC program. In an effort to better understand the pre-training, training implementation, and post-training conditions that influence training transfer, we qualitatively assessed the barriers and facilitators to implementing and sustaining new knowledge and skills gained during AETC training events. Twenty-two interviews were conducted with AETC faculty trainers throughout the country. Barriers to application included: 1) concerns about time and workload - in light of clinical priorities, training concepts may not be perceived as a high priority; 2) concerns about process and procedures necessary to apply concept; 3) lack of support from management; and 4) time lag between training and skill application. Trainers also identified several facilitators to training transfer, including: 1) provision of quality training; 2) approval of management; and 3) organization and time to implement training concepts. |
| Trainees, Settings and Contexts in Evaluation of Capacity Building: Does Our Training Program Enhance Capacity for HIV Care in Minority Communities? |
| Mari Millery, Columbia University, mm994@columbia.edu |
| Melissa Laurie, Columbia University, ml2489@columbia.edu |
| Daria Boccher-Lattimore, Columbia University, dmb82@columbia.edu |
| This presentation describes the efforts of the New York/New Jersey AIDS Education & Training Center (NY/NJ AETC) to evaluate its longitudinal HIV-training certificate program for minority and minority-serving healthcare providers in high HIV-prevalence minority communities. In the ACCESS (AETC Community Clinical Education & Sustaining Support) program, participants receive 20 or more hours of clinical training and are connected to HIV care information, resources and mentoring. Data sources for the evaluation include pre, post and 6-month follow-up surveys with trainees, trainings plans and interviews and focus groups with program staff. Indicators are included to capture increase in trainees "social capital". To date, 73 providers were enrolled in the program. The evaluation illustrates the importance of context on two levels: 1- individual trainees apply their learning within the contextual constraints of their work settings and 2- individual trainees are critical vehicles of bringing HIV knowledge to the context of high need communities. |
| Beyond Knowledge Change: An Exploratory Analysis of Clinical Contexts in a Longitudinal HIV Training Series |
| Blake Tyler McGee, Emory University, btmcgee@emory.edu |
| Rebecca Culyba, Emory University, rculyba@emory.edu |
| The Southeast AIDS Training and Education Center provides intensive, on-site training events for clinical and non-clinical service providers at outpatient facilities across the region over a one- to two-year period. To date, pre- and post-training data from this longitudinal training program reveal measurable improvements in HIV-related knowledge and skills. In particular, there was a statistically significant increase in mean score on the provider assessment tool over the first year of training at all participating sites. However, context may mitigate the application of new knowledge and skills. Therefore, we asked trainees to rate the presence of enabling factors in their clinic environments. These ratings formed an internally reliable scale that was not correlated with trainee test score change, suggesting that some learners with extensive knowledge acquisition are limited in applying training content. Additionally, trainees provided qualitative information about challenges to providing HIV care that may constitute further obstacles to training transfer. |