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"'I'm a Health Worker' - Abduaraman Gidi" made by IntraHealth International.

Dr. William Brieger of Johns Hopkins School of Public Health

Recently, CHW Central interviewed Dr. William Brieger of Johns Hopkins School of Public Health (JHSPH).  He is leading a Coursera Course on Training of Trainers (TOT) for CHWs. Coursera is an educational technology company that partners with top universities and organizations world-wide to offer courses online for free. Dr. Brieger's work is based on his experience in Oyo State, Nigeria.  He adapted the TOT from his course at JHSPH focusing on how to establish CHW training.  The 7 week course starts on October 21; you can find registration and additional information here.

Distance Learning:  How does it help health workers conduct training?  

CHW Central:  Why are online courses now being seen as appropriate methodology?

William Brieger:   TOT courses are usually done in a very specific location - e.g. District Health headquarters – that requires a financial commitment by the health department or a donor which is difficult to get. What we have done is take some of the basics of TOT for CHW training and made it freely available online.  Health workers can access it individually or in groups and use the content to plan their own local programs.

CHW Central:  What makes it work -- what ingredients are necessary?

William Brieger:  Truthfully, since the course has not run before, we have no idea whether it will work.  We have based it on our existing 4-credit paying course (Training Methods and Continuing Education TMCE) in which distance education students, many of whom are working in health agencies, use the course to design specific training programs, and often implement them.  What makes that format work is the combination of explanatory lectures and assignments that enable the participant to plan actual training sessions with feedback from the instructor. Since there may be thousands of students in a Coursera course, it is impossible for individual feedback from instructors/teaching assistants, but Coursera has a peer assessment system where at least 4 other participants review assignments and give feedback - generally this results in some quite useful suggestions.

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CHW Central: What evidence is there that distance learning is effective - is there a field follow up/feedback that tells you this methodology is working?

William Brieger:  We should say up front that Distance Learning is not everyone's cup of tea. Some people - both learners and trainers/teachers feel uncomfortable outside a face-to-face learning encounter.  Distance learning does require some level of self-direction and self-discipline since there are often not specific times and places where one must show up to learn.  On the other hand, people who have jobs, family and community responsibilities that make off-site locations or taking work hours for a course very difficult. Distance learning is ideal for such people as they can adapt it to their own schedules. 

Distance learning also has the benefit of reaching a more diverse audience and, in the case of Coursera, people who may not be able to afford formal training. Much of the feedback Coursera is getting so far is anecdotal, but valuable none-the-less. Students have mentioned the ability to take courses that are not available where they live or work; even university students say some of the free courses are not available at their own universities.  Some students have given feedback that their employers are happy with the new skills they have gained. Of course, people also talk about intrinsic benefits they perceive in terms of increased self-confidence in a technical area and the joy of learning.  As time goes on, Coursera will be doing more formal evaluation and surveys to learn from its participants.

CHW Central: How do you get over 7000 people to talk to each other?  Is that even part of the process?

William Brieger:  All Coursera courses have online discussion forums. Participants usually initiate these, though there are some standard ones set up in advance like "ask the professor".  Students have also set up private Facebook pages for the courses and use those to chat and share ideas and resources.  For my first course 12,000+ signed up, 7000+ actually accessed course materials but only 750+ actually completed and passed all assignments in order to get a certificate of attendance. Since this is similar to adult education, people who sign up have different interests and learning needs and some only want to download some materials or listen to a few lectures, while others want to begin mastering a new skill and knowledge set.

CHW Central:  Is there an expectation of some practicum work - or assignment - if so, how is that supported – especially given the size of the course.

William Brieger:  The course will have three quizzes to test people's grasp of content and a practical CHW (or other volunteer) training session planning exercise in three stages.  The first stage focuses on identifying a training issue ideally in a specific setting, defining/describing the trainees (CHWs) and their learning objectives and sub-objectives. Once feedback is given on this stage, the participants develop learning methods and identify materials and financial resources needed to conduct training around those objectives. The final stage is describing appropriate evaluation activities.  Hopefully by the end of this process, the course participants will have a sample training session they can build upon and actually implement.

• TLP Coursera
• TMCE course at JHU
• Global health Certificate


About William Brieger:

William Brieger is a Certified Health Education Specialist and has a Doctorate in Public Health (DrPH) in International Health from the Johns Hopkins University (JHU) and a Masters in Public Health (MPH) in Health Behavior and Health Education from the University of North Carolina, Chapel Hill. He is a Professor in both the Health Systems and the Social and Behavioral Interventions Programs of the Department of International Health at The Johns Hopkins Bloomberg School of Public Health and also serves as JHPIEGO’s Senior Malaria Specialist. Bill taught at the African Regional Health Education Center at the University of Ibadan, Nigeria, from 1976 to 2002. He is internationally renowned for his expertise in the social and behavioral aspects of disease control and prevention, with special emphasis formative research and behavior change program design and evaluation. A particular focus has been on training peer educators, community volunteers and other community resource persons to take an active role in health education and health service delivery. Bill RBM.jpeg


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