Effective TB Interviewing for Contact Investigation: Facilitator Led Training Guide 2006
This section will discuss issues that should be considered prior to conducting a training program. These issues include formulating why training is being conducted, for whom it is targeted, and what skills need to be addressed.
Depending on who the target audience is and where they are from, it is important to involve supervisory, state, and other staff in planning the training program. These individuals will take into consideration what outcomes they wish to see from a training program as well as make determinations on who should be trained and what staff capabilities exist. These issues may range from who is available from individual programs to attend training to a broad assessment of where poor performance indicators exist for contact investigation.
The planning committee discussion should answer
- Why a course on TB interviewing is being conducted;
- Who should attend the course, including job descriptions and titles, geographic locations (if not from the same health department located in one area), and levels of experience;
- Who should provide the training and who will provide support services before, during, and after the course;
- Who should pay for the training;
- When to conduct the training; and
- Where to conduct the training.
In order to answer the above questions, the planning committee should complete a needs assessment. A needs assessment is a process for gathering information that allows an instructor to tailor the content to the learning needs of the group. To develop a training program that will have the intended impact, you must have an accurate picture of
- Whether training is necessary and feasible;
- What topics and skills need to be developed; and
- How training should be delivered.
While the needs of the course participants in a TB interviewing course may seem obvious, some planning and assessment to address these needs is necessary. Training should be tailored to fit the level and experiences of the course participants. This course will be much more effective if it takes into consideration what the participants require and the circumstances in which they work.
There are sources from which to obtain assessment data and determine the answers to the planning committee’s questions about training.
Some of the places in which data for the planning process can be located include the following:
TB interview outcome objectives for individual TB programs. Upon reviewing these objectives, it should be determined whether they are being met. Examples of objectives include the time frame for completion of interviews and the contact index
The Aggregated Reports for Program Evaluation (ARPE) target
Review of interview data collection forms. A review should include looking at forms for completeness, accuracy, logic, and timeliness of documentation
Supervisors’ interview observations. Supervisors should periodically go into the field and observe contact investigation interviews to evaluate staff performance
Participants themselves are also a good source of information about their own training needs. They can also discuss what types of training formats and activities work best for them. When approaching the trainees, supervisors should make it known that TB interviewing training is needed and that a preliminary plan has been established. Their feedback would be useful in tailoring training to specific work circumstances. Ways in which this assessment can be done with potential trainees are
Focus groups or informal group interviews; and
Depending on whom you are speaking with and their experiences, the responses you receive may vary. How you analyze the data can be based on various factors about the participants including
Years of experience
Frequency of conducting interviews
Types of TB patients typically seen (e.g., private provider, homeless, substance abusers, foreign born)
Interview environments (e.g., hospital, home, shelter)
Below are some sample questions you may ask as part of a needs assessment interview or survey:
Have you conducted patient interviews before? If so, in what settings did these interviews take place?
Have you conducted TB interviews?
a. How comfortable are you with TB interviews? If not comfortable, what would help you become more comfortable with TB interviewing?
b. What do you enjoy about TB interviewing?
c. What TB interviewing situations do you find challenging?
d. …and why?
e. What type of patients do you find challenging to interview and why?
a. What are your expectations of how you will perform a TB interview?
b. If you anticipate any challenges, what are they?
Have you ever had interviewing training?
a. Where did you have training?
b. When did you have training?
c. What was the training like (e.g., was it specific to TB or another field of work; what was the training format)?
Since TB interviewing training will be provided:
a. What specific topics or skills would you like to see emphasized (e.g., asking open-ended questions, formulating an infectious period, maintaining confidentiality, obtaining contacts, appropriate use of body language)?
b. What methods for training do you find most effective (e.g., role-playing, watching others conduct interviews, lectures, case studies)?
c. Where, when, and for how long should training ideally take place?
Upon completion of a needs assessment, the results should be summarized. A summary report, with the results listed, will assist you and the planning committee in designing a course based on the participants’ needs. Based on what participants tell you and what supervisors also share, the training program can take shape using the teaching activities provided in this manual. The program may be shorter for more experienced persons who have demonstrated effective skills in the past but need a “refresher,” or who have never been formally trained in the past. The length of the course may also be influenced by job constraints and staff coverage.
Once topics, skills, and amount of time allotted have been determined, objectives and an agenda can be set. This manual will provide a course agenda and activities that you may modify depending on the identified needs and limitations.
Along with your planning committee or the others who are assisting you, decide a date and venue for the course. Since training should be a focused experience, free of distractions, choosing a location away from the health department is ideal. If possible, coverage should be arranged to provide an uninterrupted training experience for staff.
Try to schedule the course during regular work hours. This ensures that participants can be available for the entire course and not conflict with other responsibilities such as childcare, personal appointments, or other work. Also, continuity can be best attained if the course is held over one day rather than split between two or more days.
The learning objectives of a training program are its measurable outcomes. The objectives listed below are based on the activities provided to you in this manual. The objectives of the Effective TB Interviewing training course are for the participant to develop the skills to
Provide a comfortable interview environment for the patient;
Identify contacts based on knowledge of TB transmission and the infectious period;
Establish rapport with an index patient;
Appropriately respond to patient questions through TB education;
Utilize effective communication techniques to convey respect, sincerity, and confidence to the patient; and
Address patient’s concerns by recognizing verbal and nonverbal cues.
The above objectives may be modified based on the choice of course activities. Objectives should be incorporated as part of the evaluation activities at the end of the course to gauge whether they were accomplished.