Applying Adult Learning Best Practices to Design Immunization Training for Health Care Workers in Ghana

Improving mastery and retention of knowledge and complex skills among sterile processing professionals: A pilot study on borescope training and competency testing

BACKGROUND

Healthcare is shifting toward minimally invasive procedures requiring increasingly complex instruments and sophisticated processing technologies. Effective training methods are needed to ensure sterile processing professionals acquire and retain essential skills.

OBJECTIVE

This study aimed to develop and evaluate a new training model that supports mastery and retention of complex key skills.

METHODS

The model was pilot-tested with training focused on visual inspection of endoscopes. Pre- and post-training tests were administered to enhance learning during a face-to-face workshop that interspersed lectures and hands-on practice, followed by structured homework, and an online booster session. Surveys assessed satisfaction and confidence levels.

RESULTS

Mean test scores for nine certified sterile processing employees increased significantly following the workshop (41% vs. 84%, p<0.001). After the workshop, all trainees identified actionable visible defects on patient-ready endoscopes in their facilities. Test scores remained high after two months (90%), and trainees reported higher technical confidence and satisfaction levels after training.

CONCLUSIONS

This study demonstrated effectiveness and clinical relevance of a new, evidence-based model for training sterile processing professionals that incorporated pre-testing, lectures, hands-on practice, a training booster, and post-testing to enhance learning. This model may be applicable to other complex skills necessary for infection prevention and patient safety.

It’s Time to Move Beyond Traditional Health Care Worker Training Approaches

Isn't it time that the global community move beyond traditional training and supportive supervision models to improve health care worker capacity?

Evaluation of the Impact of Immunization Second Year of Life Training Interventions on Health Care Workers in Ghana

Applying performance-based training interventions that follow adult learning principles and include follow-up activities after training may help to solve specific performance problems and improve health care workers’ performance in immunization service delivery. These strategies facilitate learning, minimize the forgetting curve for health care workers, and should be considered as a standard practice for future training interventions.

Introduction:

As part of a suite of training interventions to improve the knowledge and practice of immunization in the second year of life (2YL), training of trainers workshops were conducted with regional and district health management teams (DHMTs) in 15 districts in 3 regions of Ghana. Using adult learning principles, DHMTs implemented several capacity-building activities at the subdistrict and health facility levels, including health facility visits, on-the-job training, and review meetings. The current evaluation investigated whether frontline health care workers (HCWs) reported or demonstrated improvements in knowledge, attitudes, and practices after training interventions.

Methods:

Quantitative and qualitative methods with a utilization-focused approach guided the framework for this evaluation. A systematic random sample of 115 HCWs in 3 regions of Ghana was selected to complete a competency survey before and after training, which focused on 3 core competency areas—Expanded Programme on Immunization (EPI) policy; communication with caregivers; and immunization data management, recording, and use. Interviews and direct observations by data collectors were done to assess HCWs’ knowledge, self-reported attitude, and behavior changes in practices.

Results:

Of 115 HCWs, 102 were surveyed before and 4 months after receiving capacity-building interventions. Modest but not statistically significant improvements were found in knowledge on EPI policy, immunization data management, and communication skills with caregivers. HCWs reported that they had improved several attitudes and practices after the 2YL training. The most improved practice reported by HCWs and observed in all 3 regions was the creation of a defaulter list.

Discussion:

Findings of this evaluation provide encouraging evidence in taking the first step toward improving HCW knowledge, attitudes, and practices for 3 core immunization competency areas. The use of learner-focused teaching methods combined with adult learning principles is helpful in solving specific performance problems (such as lack of knowledge of EPI policy).