Whole-Site Training: A New Approach to the Organization of Training
Figures 1-4, Tables 1-2

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Figure 1:
Changing the Way Training Is Done: A Comparison of Conventional and Whole-Site Training Approaches

Conventional Training Whole-Site Training
National training priorities are paramount. Site and trainee priorities are coordinated with national priorities.
Almost all training is done at centralized locations. Almost all training is done at service-delivery sites.
Donors or national bodies decide training content of most training. Sites work with supervisors to identify what training is needed for their staff in a continuous process.
Training is standardized. Training is more tailored to site and trainee needs.
Training emphasizes didactic methods. Training emphasizes interactive methods and practice.
Training is largely skills training. Training is a mixture of skills trainings, updates, and orientations (see Figure 2).
Training is in hands of master trainers. Training is in hands of supervisors and skilled practitioners at sites.
Supervisors are minimally involved. Supervisors are key players.
Site situations are addressed only through role plays and case studies. Site situations and needs are the focus of training.
Few trainees can be trained as slots are limited. Many trainees can be trained on an ongoing basis.
Senior staff or professional staff are principal trainees. All staff are trainees.
Trainees are rarely followed up. Trainees are frequently followed up.
Knowledge and skills gained are often not shared. Knowledge and skills sharing is encouraged.
Capacity building and sustainability for the site are not stressed. Capacity building and sustainability for the site are stressed.
Training in different content areas is undertaken through separate, specific courses. Training can cover different content areas in one course.
Training costs per person may be high. Training costs per person are minimized.
Services may be disrupted when staff are away. Training is scheduled to minimize service disruption.
Staff not involved in training know little about the topic or how to support the trainee. Colleagues and relevant nonclinical staff are oriented to the topic and helped to understand their role.
Caseload may be low in the compressed time period available for training. Caseload may be sufficient if training occurs over time.
Training dates are set by central trainers. Training is conducted on dates more suitable for trainees.
Trainees interact with other trainees with different backgrounds and perspectives. Trainees have limited exposure to different backgrounds and perspectives.
Maintaining standards and quality of training is easier. Maintaining standards and quality is more challenging.

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Figure 2:
Training Terminology

Off-site training:
Training events or activities conducted at a place other than the location where the trainees will be expected to utilize the knowledge or perform the skill acquired during training. Such training is often planned at a centralized level and held far from the trainees' workplace in conditions very different from those found in the workplace.

On-site training:
Training events or activities that take place in the location where the trainees will be expected to utilize the knowledge or perform the skill acquired during training.

Creating awareness and providing basic information to staff (for example, informing staff about a new medical technology, about services at the site, or about their role as team members). An orientation helps site staff support other staff members who are receiving either skills trainings or updates.

Skills training:
Designed to teach a set of skills that will enable trainees to perform specific new tasks.

Update or refresher:
An event that adds or upgrades information, knowledge, or skills related to advancements and changes in knowledge or technology (for example, contraceptive technology updates or refresher training in financial management systems). An update is often all that is required to polish previously acquired knowledge or skills.

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Figure 3:
The Six Elements of Whole-Site Training

  • Changing the role of the supervisor
  • Assessing site training needs and planning to meet them
  • Focusing on teams, not just individuals
  • Tailoring the level of training to the needs of different employees
  • Expanding the locales where training occurs
  • Building sustainable capacity

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Figure 4:
Whole-Site Training: Practical Steps for Program Managers

  1. Prepare supervisors, trainers, and skilled practitioners who will offer training. Produce materials. Orient, update, or train supervisors in the basics of training. Provide them with the knowledge and skills needed to help sites identify and meet their training needs. Encourage attitudes among them that support organizational development. Ensure that written training materials are available for the site supervisors, skilled practitioners, and others who will provide training at service-delivery sites. Train supervisors to evaluate competency levels and to certify trainees where necessary, or to organize this process.
  2. Orient supervisors in how to use on-the-job training guides to help formalize and standardize the transfer of knowledge and skills from skilled practitioners to learners. (Note: AVSC is currently developing a series of such guides.)
  3. Encourage collaboration with other agencies. Develop a roster of local expertise.
  4. Help service-site staff (including supervisors, managers, and representatives from all departments) to identify service-delivery problems and to determine if training is the answer to the identified problems. Help individuals identify their own training needs within the context of site needs.
  5. Help staff to work as a team to prepare a training plan for the site.
    • What skills training, updates, and orientations are needed: content, depth
    • Who will be trained
    • Who will train, using local resources whenever possible
    • How: didactic methods v. interactive; scheduling, coaching, mentoring, one-on-one, materials
    • Where: on-site or off-site
  6. Help staff and supervisors determine and identify training resources (trainers or skilled practitioners, materials, equipment).
  7. Help the site undertake skills training, updates, and orientation.
  8. Evaluate training in collaboration with supervisors and site staff.
  9. Evaluate acquisition of knowledge and skills by trainees, and certify the trainees. Provide support and follow-up to them. Help site staff monitor and assess competencies and performance improvement.
  10. Evaluate the training plan continuously (for example, every six months). Update it as needed.

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Table 1

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Table 2

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