I-TECH’s Clinical Mentoring Model

E. Michael Reyes, MD, MPHCoDirector, I-TECH UCSF

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Background

I-TECH was founded in April 2002 by the Health Resources and Services Administration and the Centers for Disease Control & Prevention to be the “International AIDS Education & Training Center (AETC)”

I-TECH is a joint collaboration between the University of Washington and the University of California San Francisco

Additional funds from USAID since 2003 for work in Caribbean

$30 million in total funding for 2007.

Today, I-TECH has 225 staff worldwide working from 10 field offices in partnership with approximately 100 non-governmental organizations.

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I-TECH Mission

I-TECH promotes activities that increase human and organizational capacity for providing HIV/AIDS clinical care and support in countries and regions hardest hit by the AIDS epidemic.

I-TECH supports the ongoing development of health care worker training systems that are locally-determined, optimally resourced, highly responsive and self-sustaining. Project efforts target development and support of training content, delivery and systems.

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CountriesI-TECH supports capacity development in 25 countries, including more

than a dozen countries in the large Caribbean region.

Botswana

Caribbean (Antigua, Bahamas, Barbados, Dominica, Grenada, Guyana, Haiti, Jamaica, St. Kitts & Nevis, St. Lucia, St. Vincent & the Grenadines, Surinam, Trinidad & Tobago)

Ethiopia India Kenya Malawi Mozambique Namibia South Africa Tanzania Thailand Vietnam Zimbabwe

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Clinical Mentoring Overview

I-TECH builds on nearly two decades of experience from the 11 U.S.-based AIDS Education and Training Centers. I-TECH also uses evidence-based training practices derived from literature on health behavior change, adult learning theory, and clinical care.

Our clinical mentoring approach is consistent with World Health Organization guidelines.

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Clinical TrainingFive Levels of Training - Adapted from U.S. AETCs

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Clinical Mentoring Toolkit

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Objectives of the Toolkit

To facilitate successful clinical mentoring encounters

To support clinical mentors who are working in varied clinical settings in resource-constrained countries

To provide a set of adaptable tools for in-country providers

To provide a practical resource to organizations conducting clinical mentoring-like activities

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Use of Toolkit

NOT meant to be prescriptive!

No two mentorships are alike

Tools are designed to be adaptable

NOT a substitute for skilled trainers/mentors

Mentors can use it to help inform activities, but they are ultimately responsible for organizing materials in a coherent and appropriate manner

Designed as a resource for both mentors and persons at facilities in the absence of mentors

A capacity building product

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Development Process: Version 1

Formulated an outline of the different components of the toolkit at a clinical mentoring meeting with I-TECH staff in July 2005

Compiled resources developed by I-TECH staff and clinical consultants that could lend themselves to field work for inclusion in the toolkit

Contracted with consultants and had staff fill in some missing gaps

Conducted small number of usability tests and content review of the toolkit in January 2006

Finished a pilot-version February 1, 2006

Version one completed in July 2006

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Seven Sections of Toolkit

Overview of Clinical Mentoring: I-TECH's approach.

Getting Started: Hiring mentors and site preparation.

Needs Assessment: Provider competencies and systems.

Training: Training methods, communication, and TOT worksheets.

Curricula: Courses, workshops, and video.

Monitoring and Evaluation: Methods and tools.

Resources: References materials, glossary, image library, Web materials

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Clinical Mentoring Toolkit Multi-platform organized to accommodate lowest IT

denominator: CD-ROM

http://www.go2itech.org/HTML/CM06/toolkit.html

Original Version 1.1 launched at World AIDS Conference in Toronto in August 2006

Widely disseminated 300+ requested via website from over 45 countries

300+ distributed in Toronto

Average visitors to online toolkit version: 56 hits/day

Total files downloaded from website: 20,500+

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Next Steps – Revise Toolkit

Solicit feedback and participation of partners using online survey https://catalysttools.washington.edu/survey/sburnett/42240

Review, revise, adapt or remove existing materials

Develop and pilot new tools Prioritization of what mentor can affect, what is achievable

and how to prioritize a certain number of tasks to make them meaningful

Identifying and training leaders during mentorship

Anticipating barriers during mentorship and addressing them

How to teach history taking, differential diagnosis and physical exam skills

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Next Steps – Revise Toolkit (2)

Organize around core competencies for clinical mentors

Expand image library

Capture lessons learned and experiences from clinical mentors

Translate into multiple languages

Portuguese

Spanish

French

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Sample Competencies

Assessing and improving your skills as a clinical mentor.

Identifying and training potential clinical mentors among your on-site trainees.

Assessing and improving the HIV-specific knowledge and practice skills of trainees.

Constructing and evaluating a clinical mentoring project at a clinical site.

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Track 1.0 Partner Expertise

Pediatric mentoring

Family Centered Care

Integration of TB/HIV, PMTCT/HIV

Focus on outcomes over time

Multiple tools and curricula

Nursing expertise

Documenting lessons learned

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Launch date for Version 2.0: August 2008 at World’s AIDS Conference in

Mexico City

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Expect to hear from us…