Trainer's Guide for
Cancer Education
National Institutes of Health
National Cancer Institute
Table
of
Contents
Table of Contents
How to Use the Trainer's Guide ................................................................. 1
I. Adult Learning Principles ....................................................................... 3
1. Introduction ......................................................................................... 3
2. Principles of Adult Learning ............................................................. 5
3. Conducting a Participant Strengths and Needs Assessment ...... 12
II. Plan ........................................................................................................... 17
1. Defining an Appropriate Plan,
Training Goals, and Objectives ..................................................... 17
2. Selecting Appropriate Training Methods ..................................... 22
· Presentation/Lecture/Panel Discussions .................................. 24
· Small Group Discussion .............................................................. 27
· Brainstorming ................................................................................ 31
· Case Study ..................................................................................... 34
· Demonstration ............................................................................... 38
· Role Play ...................................................................................... 41
· Creative Work ............................................................................... 45
3. Choosing Audiovisual Materials .................................................... 49
4. Crafting a Realistic and Effective Training Plan ......................... 55
III. Implement ............................................................................................. 63
1. Creating a Safe and Comfortable Learning Environment ........... 63
2. Facilitating the Training Experience ............................................... 67
3. Using Icebreakers and Energizers ................................................. 79
4. Conducting Closing Activities ........................................................ 81
5. Evaluating the Training .................................................................... 83
IV. Summary and Conclusion ................................................................... 85
Reference List .............................................................................................. 87
Appendix A: Examples of Icebreakers, Energizers, Closing
Activities, and Training Evaluations...................................................... 89
Icebreakers
· Paired Interviews .......................................................................... 89
· Go-Rounds ..................................................................................... 91
Energizers
· Beach Ball Toss .............................................................................. 92
· That's Me ........................................................................................93
Closing Activities
· Closing Statements and Handout ............................................... 94
Training Evaluations
· Form (Version A) ........................................................................... 96
· Form (Version B) ........................................................................... 98
· Feedback Cards Exercise ........................................................... 100
· Head, Heart, and Feet Exercise .................................................. 101
· Faces Exercise .............................................................................. 103
Appendix B: Worksheets for Planning and Implementing
a Training Session ..................................................................................... 5
105
· Trainer Skills Checklist .................................................................. 105
· Training Assessment Worksheet .................................................. 107
· Questions to Help Define Appropriate Training Plan,
Goals, and Objectives .................................................................... 108
· Sample Training Plan Template..................................................... 111
· Training Plan Worksheet ............................................................... 113
· Developing Appropriate Goals and
Objectives Worksheet .....................................................................114
How
to
Use
the
Trainer`s
Guide
1
How to Use the Trainer's Guide
The guide is divided into four sections:
I. Adult Learning Principles
II. Plan
III. Implement
IV. Summary and Conclusion
Appendix B contains worksheets and tools to help you apply the
information to future trainings. You may choose to read this guide
from cover to cover and then apply the information to a training
or you may want to use sections or tools as a reference during
planning or implementation of your training session. The following
table provides an overview of each section and its contents.
Trainer's Guide Overview
I. Adult Learning
1. Introduction
Principles
2. Principles of adult learning (underscores the importance
of using the adult learning cycle to help participants apply
skills learned beyond the training)
3. Assess participants' strengths and needs to design an
appropriate training
II. Plan
1. Defining an appropriate plan, training goals, and
objectives
2. Selecting appropriate training methods (seven commonly
used training methods are explained)
3. Principles for selecting and using audiovisual materials
4. Tips for developing a realistic, responsive training plan
III. Implement
1. Ways to create a safe and comfortable learning
environment
2. Tips on facilitating the training, including giving feedback,
managing time, and ensuring cultural sensitivity
3. Ways to actively engage participants using icebreakers and
energizers
4. Ideas on how to provide closure
5. Evaluation methods
IV. Summary and
Puts it all together
Conclusion
Appendixes
Appendix A provides examples of icebreakers, energizers,
closing activities, and training evaluations
Appendix B contains worksheets to apply concepts and tips
discussed throughout the guide
How to Use the Trainer`s Guide
1
I.Adult
Learning
Principles
I. Adult Learning Principles
1. Introduction
Education is one tool in the fight against cancer. Fully informed
health care professionals and consumers can act more effectively
to care for their patients, themselves, and their loved ones. It is
vitally important that everyone learn how to decrease their
risks for getting cancer, the importance of screening and early
detection, and ways to access various treatment options.
Cancer education can take many forms: individual counseling
and education, group training sessions, media campaigns, and
printed materials such as brochures, pamphlets, and newsletters.
This trainer's guide is designed for both lay people and health
professionals who are conducting group-training sessions with
community and scientific audiences. It offers practical suggestions
for taking your knowledge, tailoring it to the specific needs of
your audience, and packaging the information in new ways. The
guide provides ways to enliven your training, encourage more
active participation, and enrich the learning experience for
everyone involved.
The trainer's guide also provides examples of icebreakers,
energizers, and closing activities as well as checklists and charts
to help you write objectives, develop a training plan, and conduct
an evaluation.
Guiding principles that serve as underpinnings for the development
of this trainer's guide are:
· We all have incredible assets to bring to the training experience.
You, as trainers, already have a wealth of information and skills.
This trainer's guide is merely an opportunity to review, refresh,
and reinvigorate your training. This guide also describes ways
to elicit the experiences and skills of your participants so that
they are actively engaged in the learning experience.
Adult Learning Principles
3
· Application is an important part of any learning experience. Just
as the trainer's guide encourages you to construct opportunities
for your participants to apply their new information and skills
during your training, it also provides you with a chance to do
the same. Most sections have worksheets that give you an
opportunity to apply the information from that section.
· Changes in knowledge, attitudes and behaviors, and skills are
primary objectives. The trainer's guide provides suggestions for
ways to use training methods that lead to increased information
and skill acquisition, and to improved attitudes.
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TRAINER'S GUIDE FOR CANCER EDUCATION
2. Principles of Adult Learning
All trainers should understand the principles of adult learning;
however, cancer education poses some unique challenges. The
word "cancer" still strikes fear in the hearts and minds of many
people. Participants in your training sessions may come with a
number of emotions, unresolved feelings, fears, and concerns that
will influence their receptivity to the training content. They also
may bring experiences, perspectives, and insights that will enrich
the training. Thus, cancer education is not just a matter of
presenting new information to a passive, receptive audience. The
trainer must carefully consider the emotional context in which
this education takes place.
Malcolm Knowles, often referred to as the "father of adult
education," found that adult learning occurs best when it follows
certain principles. If trainers follow these guidelines, they will
greatly enhance the learning experience for participants (Knowles,
1990). Arnold et al. (1991), among other adult educators, state that
people retain:
· 20 percent of what they hear
· 30 percent of what they see
· 50 percent of what they see and hear
· 70 percent of what they see, hear, and say (e.g. discuss, explain
to others)
· 90 percent of what they see, hear, say, and do
Therefore, for participants to retain what they learn in cancer
education workshops, they need a chance not only to hear a
lecture or discussion, see a demonstration or visual aids, and
discuss the material, but they must also have an opportunity to do
something with the new information and skills. This can take the
EXAMPLE
form of applying their new insights to a case study or role play
exercise, or it can take the form of developing an action plan of
ways to use their training insights in real life.
It is also important to remember the adult learning cycle.
Participatory training is the hallmark of adult learning. It moves
participants through the four phases of the adult learning cycle
described on page 7.
Adult Learning Principles
5
Participants learn best when...
The role of the trainer is to...
· They feel valued and respected for
· Elicit participants' experiences and
the experiences and perspectives they
perspectives
bring to the training situation
· The learning experience is active and
· Actively engage participants in their
not passive
learning experience
· The learning experience actually fills
· Identify participants' needs and tie
their immediate needs
training concepts into these identified
needs
· They accept responsibility for their
· Make sure that training content
own learning
and skills are directly relevant to
participants' experiences so that
they will want to learn
· Their learning is self-directed and
· Involve participants in deciding on the
meaningful to them
content and skills that will be covered
during the training
· Their learning experience addresses
· Use multiple training methods that
ideas, feelings, and actions
address knowledge, attitudes, and skills
· New material is related to what
· Use training methods that enable
participants already know
participants to establish this relationship
and integration of new material
· The learning environment is
· Take measures to ensure that the physical
conducive to learning
and social environment (training space) is
safe, comfortable, and enjoyable
· Learning is reinforced
· Use training methods that allow
participants to practice new skills and
ensure prompt, reinforcing feedback
· Learning is applied immediately
· Provide opportunities for participants
to apply the new information and skills
they have learned
· Learning occurs in small groups
· Use training methods that encourage
participants to explore feelings,
attitudes, and skills with other learners
· The trainer values their contributions
· Encourage participants to share their
as both a learner and a teacher
expertise and experiences with others
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TRAINER'S GUIDE FOR CANCER EDUCATION
Using the Adult Learning Cycle
(1)
Experiencing
(doing an exercise or
activity together or
drawing on a shared
experience)
"Doing"
(4)
(2)
Applying
(developing an action
Processing
plan for post-training or
(sharing observations
real-life situations using
and feelings about the
insights gained from the
experience)
two previous phases)
"Reflecting"
"Taking Action"
(3)
Generalizing
(examining the meaning of
the experience, comparing it
to other experiences, and
identifying general principles
or patterns)
"Deriving Meaning"
It is important to move participants through this cycle at least
once per module or 4-hour session. If your training will be more
than 4 hours in length, it will be necessary to complete
proportionately more full cycles.
Adult Learning Principles
7
Applying the Adult Learning Cycle to Cancer
Education: An Example
Let's look at how a training program on cancer survivorship
might move participants through this cycle.
Once the trainer has set the stage for the training, reviewed the
agenda, and conducted an icebreaker, he or she can move through
the adult learning cycle.
Phase 1: Experiencing
The trainer might first lead an activity designed to get participants
talking about how receiving a cancer diagnosis impacts their life.
If all of the participants were cancer survivors, the trainer would
know that everyone has had the experience of first learning their
diagnosis, so a small group discussion might be an appropriate
beginning place. However, if some participants were not survivors
but were social workers from an oncology unit, the design of
this activity should be modified. Since they have not necessarily
personally experienced the feelings associated with a cancer
diagnosis, a small group discussion would not be appropriate as
a beginning place. A more appropriate beginning might be a
panel presentation by a group of survivors.
Phase 2: Processing
The trainer would then lead a discussion about what people heard
during their small group discussions or what feelings the panel
aroused in them.
Phase 3: Generalizing
The next part of the discussion might lead to a comparison
between getting a cancer diagnosis and other life-altering news.
Phase 4: Applying
The trainer would then encourage all participants to think of ways
they might use these new insights. For oncology social workers,
the discussion might yield insights that would help them be more
compassionate and understanding with their newly-diagnosed
patients. For cancer survivors, the discussion may have generated
ideas to take back to their support groups or about how to get
more support for themselves.
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TRAINER'S GUIDE FOR CANCER EDUCATION
Repeating the Cycle
The trainer would then move to the next activity and the adult
learning cycle would be repeated using the same structure of
experiencing, processing, generalizing, and applying.
(1)
Experiencing
how receiving a
cancer diagnosis
impacts one's life
(2)
(4)
Processing
Applying
discussion about what
think of ways they might
people heard during their
use these new insights in
small group discussions or
their jobs
what feelings the panel
aroused in them
(3)
Generalizing
comparison between getting
a cancer diagnosis and other
life-altering news
Adult Learning Principles
9
Ensuring that the Training Addresses the Fact that
People Learn in Different Ways
Trainers must be aware that in any audience the participants will
learn in different ways:
For participants who...
Use
· Resonate with abstract
· Case studies and
concepts and lectures
discussions about theories
and research
· Learn best while observing
· Demonstrations and videos
others
· Learn best from exercises
· Role playing and other
experiential activites
· Learn best through visual
· Videos, images, and slides
means
Since trainers are unlikely to know the individual learning styles of
the participants in their audience, it is best to assume that there are
people with all learning styles in each group and design a variety of
strategies to meet the learning needs of all participants. These
training methodologies will be discussed in detail in section II.2.
It is also important to consider the learning strategies to which
different audiences are accustomed. For example, health care
professionals are used to learning from lectures, demonstrations,
and case studies. They may be less used to learning via experiential
exercises and some of the creative strategies listed in section II.2.
On the other hand, community members and groups of survivors
or patients and family groups may prefer more interactive methods
over lectures and PowerPoint presentations.
Trainers need to be judicious about matching training methodologies
to the specific audience. This does not mean that health care
professionals will never respond to experiential exercises, nor that
community groups will never benefit from lectures. However, it
does mean that training methods that the audience is not
accustomed to should be used in moderation and with sensitivity.
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TRAINER'S GUIDE FOR CANCER EDUCATION
For example, the trainer might warm up an audience of health care
professionals by using experiential methods such as small group
discussions about a case study before using role plays. Likewise,
community groups might prefer lecturettes (i.e., brief lectures of no
more than 15-20 minutes) followed by a question and answer
period rather than a lengthy lecture.
Trainers will be most effective if they carefully consider the
"culture" of their audience when choosing appropriate
methodologies. In this way, participants can be carefully
encouraged to explore new ways of learning.
Assisting Participants in Being Comfortable with
the Learning Process
One of the trainer's primary tasks is to help participants feel
comfortable with the learning process. There are many factors
that hinder learning, such as fear of finding out that one's lifestyle
predisposes one to a higher risk of cancer, fear of exposing one's
ignorance to others, or fear of stirring up painful memories of loved
ones lost to cancer. By creating a positive and non-threatening
learning environment, the trainer can reassure the participants
that these feelings are normal and will be carefully considered
throughout the course of the training session.
Adult Learning Principles
11
3. Conducting a Participant Strengths and
Needs Assessment
Before designing a program that is "one size fits all," it is
important to conduct an assessment of participants' prior
knowledge and experience as well as their hopes and expectations
for the training. This can be accomplished through a variety of
mechanisms that are employed before or at the very beginning
of the training. It is important to keep in mind that training
participants will bring a number of strengths and experiences as
well as the need for new information, insights, and skills. Often
assessments focus on "needs" but a comprehensive assessment
should include both the strengths and needs of participants.
Before the Training
If you know the backgrounds of the people (i.e., general
community members, health care professionals, or cancer patients
and survivors) who will be participating in the training, you can
conduct an assessment before planning the content and format.
The best case scenario is to do this assessment with some or all of
the people who will actually be participating in the training.
If you do not have a roster of who will be participating or your
time is limited, another option is to conduct an assessment with
key informants (i.e., people who may be demographically
matched to those who will be participating, such as oncology
nurses, survivors from a local support group, etc.). With this
information, you will be able to design a training that builds on
the strengths of the participants in order to add new information,
develop new skills, and enhance understanding. Assessment
methods that work well with particular participant groups
include the following:
Audience
Assessment method
Specific Participants
Method of Assessment
Health care professionals
E-mail, fax-back, or telephone
surveys
Community members
Focus groups, in-person
or survivors
interviews, or telephone
surveys
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TRAINER'S GUIDE FOR CANCER EDUCATION
It is important to include enough people in your assessment to
cover a variety of perspectives and experiences. For example, if
you were conducting a community training on the importance of
colorectal screening, it would be important to include a variety of
health care providers (e.g., physicians, nurses, social workers, and
EXAMPLE
health educators), general community members, colon cancer
survivors and their family members, etc. This would give you a
fuller picture of the knowledge and experience the community
participants will bring to the training.
Possible questions include:
· What do participants already know about the topic?
· What experiences or insights related to the topic do participants
already possess?
· What do participants believe are the challenges or barriers
related to the issue? (For example, why do they think people do
not avail themselves of colorectal screening services?)
· What do participants hope to gain from the training? (This
includes new knowledge, skills, resources, etc.)
· What do participants desire regarding the logistics of the
training (e.g., location of training, length of program, optimal
number of days of training, best day of week, time of day, etc.)?
The more specific the questions, the more useful the feedback will
be. You can then use the information to develop the content and
format of the training as well as to guide decisions related to
training logistics. Assessments can pique community members'
interest in the training topic as well as gather data for planning.
If you do not have access to community members or enough time
to conduct an assessment, it is also helpful to review evaluations
from prior training programs.
Consider using the "Training Assessment Worksheet," in
appendix B to design your own training assessment.
Adult Learning Principles
13
At the Beginning of the Training
If you are not able to conduct an assessment before the training,
there are a variety of techniques that can be used to determine
participants' knowledge and expertise as well as their hopes for
the training that day.
Hopes and Expectations
One quick way to conduct an assessment is to ask participants
to write down their hopes and expectations about the training as
they arrive. One way to accomplish this assessment follows:
· Post sheets of flipchart paper on the walls of the training room
with titles such as "one to two things I hope to learn at this
training" and "one to two concerns I have about this training."
· Ask each participant (as they enter the training room) to write
their comments on the flipchart paper.
· Review all of the comments.
· Let participants know which expectations will likely be met
through the training and which may be beyond the scope of the
training.
For example, if one of the participants wrote that he was
concerned that the trainer would use too much technical language
or difficult scientific concepts, the trainer can reassure him by
saying, "Some people seem concerned that this training will have too
many concepts that are difficult to understand. We are really going to try
hard to make the concepts as user-friendly as possible. However, if we
EXAMPLE
start using scientific jargon or talk about things you don't understand,
please let us know at that time or talk with one of the trainers during a
break. We really want this training to be meaningful for everyone, so
please help us by asking questions and giving us feedback."
For another example, if someone wrote that she wanted to find
specific clinical trials for a particular stage of colon cancer, the
trainer might state, "Actually, we won't be covering that specific
information but I can refer you to the NCI Web site for clinical trials and
give you the toll-free telephone number to call for more information." In
this manner the trainer can be a helpful resource for topics outside
the scope of the training. However, if a number of participants
EXAMPLE
have hopes and expectations that are not covered in your training
plan, it would be helpful to take time to address these
expectations before moving on with the training as you
have planned.
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TRAINER'S GUIDE FOR CANCER EDUCATION
This approach is respectful of peoples' perceived needs and
eliminates one impediment to learning. If you feel that it is
necessary, you can even revise your agenda by spending time
addressing the needs of your participants and discarding a less
important portion of the training. In this case, flexibility is key.
Group Snapshots
Another quick way to assess participants' knowledge or
experience is to take a group "snapshot." To do this, give
participants a series of questions, and ask for a show of hands if
the question pertains to them. For example, you might ask:
· How many of you know someone who has been screened for
colorectal cancer?
· How many of you know someone who has been diagnosed with
colorectal cancer?
EXAMPLE
· How many of you know the screening recommendations for
colorectal cancer?
This information can help the trainer structure or restructure
activities to more closely draw on the participants' experiences
and meet their needs.
Throughout the Training
The following strategy is not considered an assessment strategy.
However, it is a way to continue the assessment process
throughout the training. A good trainer is able to read the body
language of the participants to ascertain the appropriateness of
the content, the pace of the training, and the energy level in the
group. This technique is further discussed in section III.1.
In summary, the needs and strengths assessment provides
invaluable information that will assist the trainer in developing
appropriate training goals and objectives.
Adult Learning Principles
15
II.
Plan
II. Plan
1. Defining an Appropriate
Plan, Training Goals, and Objectives
To develop an effective training plan that achieves
the point of the educational session: i.e., to make changes in
knowledge, attitudes, behaviors, and skills, a number of key
questions must be answered. Some of these questions will
be addressed in the needs assessment. The answers to these
questions will affect the content, format, and logistics of the
training. The following questions are a guide.
Questions
Who are your participants?
· What is their educational level?
· What is their experience and skill level?
· What gender and age are they?
· Are they employed?
· What kind of work do they do?
· Do they work together?
· What is their literacy level?
· How many will there be? (approximately)
When will you conduct the training?
· What day of the week?
· What time of day?
· What time of the year?
· How long will the session be?
· What will be the length of the entire program?
· How much time is there for recruitment?
Where will you conduct the training?
· What is needed?
What size room is needed?
What equipment is available?
What other supplies are needed?
Plan
17
· Location
Is the location accessible?
Is the location easy to find?
Can it be reached by public transportation?
Is there safe parking?
Is it handicap accessible?
Is it a place that does not have negative connotations for
intended participants (e.g., some places are associated with
poor service or indigent care, which may make some
participants uncomfortable)?
What will the training involve?
· What will be the content of the training plan?
· What training tools will be needed?
· What participant materials and resources will be needed?
· Will there be advance work for participants?
What is the purpose of the training?
· What changes in knowledge, attitudes, behaviors, and skills are
you hoping to accomplish through the training?
· What are the goals and objectives of the training?
How will you do it?
· How will you enroll people for the training? Some possible
recruitment strategies include: flyers; PSAs on TV and radio;
ads in newspapers and newsletters; and word of mouth.
· How will you engage participants?
· How will you get feedback or evaluate the effectiveness of your
training?
Once these questions have been answered, the training goals
and objectives can be developed. The following section provides
definitions and examples of goals and objectives.
Consider using the "Questions to Help Define Appropriate
Training Plan, Goals, and Objectives Worksheet" in appendix B.
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TRAINER'S GUIDE FOR CANCER EDUCATION
Setting Goals and Objectives
Goals
Goals are broad, general statements of what one hopes to accomplish
as a result of the training. An example of a goal might be:
"Increased awareness of the importance of cancer
clinical trials."
Objectives
Objectives should describe the hoped-for changes in knowledge,
attitudes, skills, or behaviors in very precise terms. Usually they
are written in the following manner:
"By the end of this training (session), participants will be able to
__________________________."
The word that follows `to' should be an action verb.
For objectives to be helpful in determining training effectiveness,
they should be measurable (e.g., "list five common myths about
mammography" or "compare three ways that barriers to cervical and
breast cancer screening are similar"). Attainment of training goals
and objectives is one important aspect of the evaluation. Not all
objectives are easily measured but most can be evaluated using
standard evaluation tools or other creative strategies.
There are seven types of objectives:
· Fact
· Understanding/comprehension
· Application
· Analysis
· Synthesis
· Attitudinal
· Skill
Depending on what you hope to accomplish through the training,
some or all of these types of objectives need to be developed.
Keep in mind the adult learning cycle described in section I.2
when developing your training objectives. Fact, understanding,
attitudinal, and skill objectives might pertain to the "experiencing"
part of the cycle; analysis and synthesis might pertain to the
Plan
19
"processing" and "generalizing" parts of the cycle; and application
objectives might pertain to the "applying" stage. Remember to move
participants around the adult learning cycle at least one time per module
and design objectives accordingly.
When writing the seven different types of objectives, the trainer might
find the following chart of verbs helpful.
Seven Training Objective Types
1. Fact
· Define
· List
· Recall
objectives:
· Name
· Repeat
· Recognize
· Record
· State
· Record
2. Understanding
· Discuss
· Identify
· Express
or comprehension · Describe
· Translate
· Convert
objectives:
· Explain
· Restate
· Estimate
3. Application
· Compute
· Operate
· Apply
objectives:
· Demonstrate
· Perform
· Use
· Illustrate
· Interpret
· Practice
4. Analysis
· Solve
· Distinguish
· Differentiate
objectives:
· Compare
· Contrast
· Categorize
· Appraise
· Classify
· Critique
5. Synthesis
· Synthesize
· Diagnose
· Propose
objectives:
· Design
· Manage
· Hypothesize
· Summarize
· Plan
· Formulate
6. Attitudinal
· Show
· Accept
· Be willing
objectives:
sensitivity
responsibility
to assist
· Respect
· Demonstrate
opinions
commitment
7. Skill
· Perform
· Compute
· Operate
objectives:
· Demonstrate
· Teach
· Complete
· Show
· Role play
· Design
· Conduct
· Take
· Do
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TRAINER'S GUIDE FOR CANCER EDUCATION
Some examples of learning objectives that trainers expect participants to achieve are
listed below:
Seven Learning Objective Types
Fact objective:
By the end of this training, participants will be able to:
List four risk factors for skin cancer.
Understanding
objective:
By the end of this training, participants will be able to:
Describe three ways parents can protect their children
from the harmful effects of UV radiation.
Application objective: By the end of this training, participants will be able to:
Demonstrate their ability to use NCI's Physician Data
Query to research information on cancer clinical trials
related to two case studies.
Analysis objective:
By the end of this training, participants will be able to:
Contrast the barriers to fecal occult blood testing and
colonoscopy by naming two barriers that are similar and
two barriers that are different.
Synthesis objective:
By the end of this training, participants will be able to:
Design an action plan to increase community awareness
of the importance of cancer clinical trials through working
within their own community-based organizations.
Attitudinal objective:
By the end of this training, participants will be able to:
Demonstrate a commitment to increasing the number of
women aged 50 years or older who get mammograms by
agreeing to tell five friends in the next 3 months to
schedule a mammogram.
Skill objective:
By the end of this training, participants will be able to:
Perform a correct clinical breast exam using the vertical
strip method by demonstrating this to the trainer during
a simulation exercise with two standardized patients.
Consider using the "Developing Appropriate Goals and Objectives Worksheet" in
appendix B to develop your own training goals and objectives.
Plan
21
2. Selecting Appropriate Training Methods
Suggested Methods for Creating Behavior Changes
through Training
To help people gain new awareness and information that will
translate into changes in attitudes and behavior, you must choose
training methods that correspond to the changes you hope to
accomplish. A variety of training strategies will ensure that the
learning needs of all types of participants are met. The list below
provides some suggested training methods for accomplishing
changes in each of these domains. A description of some of the
more common training methods, their advantages and
disadvantages, and how to implement them follows the list.
Knowledge (Concepts, Facts)
· Computer-assisted instruction
· Discussion
· Field trip or tours
· Films, TV, tapes
· Handouts
· Lecture
· Programmed instruction
· Readings
Attitude (Feelings, Opinions)
· Brainstorming
· Case studies
· Creative arts
· Field trips
· Interview situations
· Open-ended discussions
· Panel presentations of survivors, family members, or health
professionals
· Role playing
Behavioral Skills
· Action plans
· Demonstrations
· Guided practice with feedback
· Practicums
· Role playing
· Simulations
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TRAINER'S GUIDE FOR CANCER EDUCATION
Training Methods Overview
The following table summarizes which of the training methods
described below can be used to achieve changes in participants'
knowledge, attitudes, and behavior skills.
Training Method
Knowledge
Attitude
Behavior Skilll
1. Lecture
X
2. Small Group Discussion
X
X
3. Brainstorming
X
X
4. Case Study
X
X
X
5. Demonstration
X
X
6. Role Play
X
X
X
7. Creative Work
X
X
Note: For tips on how to facilitate an entire training, see Section III.2.
Once you review all of the training methods, consider using the
"Training Plan Worksheet" and/or the "Training Plan Template"
in appendix B.
Plan
23
Training Method #1: Presentation/Lecture/Panel
Discussions
A presentation or lecture can convey information, theories, or
principles quickly and easily. Some examples specific to cancer
education might be reviewing the epidemiology of a specific type
of cancer or reviewing a current screening protocol. Presentations
can range from straight lecture to some involvement of the
participants through questions and discussion. Presentations
depend on the trainer for content more than any other training
technique does.
Uses
· Introduces participants to a new subject
· Provides an overview or a synthesis
· Conveys facts or statistics
· Addresses a large group
Advantages
· Covers a lot of material in a short time
· Works with large groups
· Provides context for more practical or hands-on training
techniques
· Gives lecturer or presenter more control than in other training
situations
Disadvantages
· Emphasizes one-way communication
· Is not experiential in approach
· Requires that participants take passive role in their learning
· Requires that lecturer possess skills as an effective presenter
· Is not appropriate for changing behavior or for learning skills
· Limits participant retention unless it is followed up with a
more practical technique
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TRAINER'S GUIDE FOR CANCER EDUCATION
Process
1. Introduce the topic: Tell the participants what you are going to tell them.
Use an opening that:
· Explains the purpose of the presentation and why it is important
· Relates to the topic, situation, participants, or speaker
· Involves and stimulates the audience
· Creates positive thinking and peaks interest
· Gets attention, for example, by using:
Questions
Unique facts
Illustrations
Quotations
Brief stories
Jokes (in good taste)
Gimmicks
Compliments
Subject matter of significance
· Serves as a preview to subject matter
2. Present the topic
3. Hold participant attention and interest by:
· Being enthusiastic, dramatic, or humorous
· Using specific examples that:
Provide clarity, color, and credibility
Help a general thought become a specific one
Make the impersonal become more personal
· Avoiding jargon
· Varying the pace
· Providing opportunities for participant involvement, by:
Questioning both ways
Acknowledging individuals, by name, if possible
Asking for participant assistance
· Using references that show material is aimed at a specific group
· Using surprises and extras
· Inviting the participants to ask questions
4. Use a closing that:
· Summarizes the entire activity and emphasizes the key
"take home" message
· Makes a meaningful statement
· Relates to the topic, situation, participants, or speaker
· Ties together the activity as an entity
Plan
25
Variations
A lecturette is a term used for a brief (e.g., no more than 15-20
minutes) presentation or lecture. Often these are made more
interactive by using a "call and response" format such as
interspersing questions to the participants in between lecture
points made by the presenter. For example the trainer might ask,
"Which communities or populations are most impacted by cervical
cancer?" After participants offer answers, the trainer could then
validate the right answers, correct misinformation or wrong
answers, and then briefly summarize the take-home messages.
In this manner, participants are acknowledged for what they
already know while new and accurate information can be offered
by the trainer.
Another variation on the presentation method is a panel discussion.
A group of experts (e.g., cancer survivors, family members, or
health professionals) present their perspectives to the participants
through prepared remarks or spontaneous answers to questions
posed by a moderator or facilitator. This approach can be made
more interactive by allowing time for participants to ask questions
or make comments. A moderator or trainer can model this
interaction by asking one or two questions to "prime the pump."
Participants can also write their questions on index cards if the
size of the training group makes it logistically difficult for
participants to ask questions verbally.
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TRAINER'S GUIDE FOR CANCER EDUCATION
Training Method #2: Small Group Discussion
A small group discussion is an activity that allows participants to
share their experiences and ideas or to solve a problem. It exposes
participants to a variety of perspectives and experiences as they
work together to accomplish the task. Some examples specific to
cancer education include breaking people into small groups to
discuss ways to encourage more people over the age of 50 to have
regular colorectal screenings or, for a health care professional
audience, ways to improve cancer pain management.
Uses
· Enables participants to present their ideas in a small group
· Enhances problem-solving skills
· Helps participants learn from each other
· Gives participants a greater sense of responsibility in the
learning process
· Promotes teamwork
· Clarifies personal values
Advantages
· Allows participants to develop greater control over their
learning
· Encourages participants to be less dependent on the trainer
· Encourages shy or less talkative participants to become
involved
· Allows for reinforcement and clarification of the lesson
through discussion
· Builds group cohesion
· Elicits information from participants
Disadvantages
· Takes time to move people into groups
· Compromises quality control if a trained facilitator is not in
each small group
Plan
27
Process
1. Arrange the participants in small groups using some of the
ideas listed on page 30
2. Introduce the task that describes what should be discussed in
the small group
3. Tell participants how much time they have
4. Ask each small group to designate:
· A discussion facilitator
· A recorder
· A person who will present the group's findings to the larger
group
5. Check to make sure that each group understands the task
6. Give groups time to discuss
7. Circulate among the small groups to:
· Clarify any questions participants may have
· Make sure that participants are on task
· Make sure that a few participants are not dominating
the discussion
8. Bring all of the small groups together to have a large group
discussion
9. Have the people designated by each group present a
summary of their group's findings (this could be a solution to
a problem, answers to a question, or a summary of the ideas
that came out during the discussion)
10. Identify common themes that were apparent in the groups'
presentations
11. Ask the participants what they have learned from
the exercise
12. Ask them how they might use what they have learned
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TRAINER'S GUIDE FOR CANCER EDUCATION
Determining Group Size
Participants learn through their own experience, especially by
discussing questions posed by the trainer. Discussions can
take place in a large group, in a small group, or between two
participants. The following information is useful in determining
the appropriate size of the group for specific activities.
· Most people find it difficult to speak in a group of strangers.
Also, there is usually not enough time for everyone to speak.
Therefore, if everyone is to participate actively, small groups
are essential.
· Most people find it difficult to listen attentively for long
periods. Therefore, talks should be short, and people should be
given an opportunity to discuss a topic or issue in small groups.
· We all remember much better what we have discovered and said
ourselves than what others have told us. Therefore, participants
should be given questions leading them to express all they have
learned from their own experience first. This needs to be done in
small groups.
· A resource person or facilitator can briefly sum up the points
from each group and add his or her own insights later, instead
of taking a long time to tell people what they know.
· Pairs are useful for:
Interviews
Intimate sharing
Practicing some skills (e.g., listening or feedback)
A quick "buzz" with one's neighbor to stir a passion or
prompt a sleepy group into action
For example, if your group consists of breast cancer survivors,
participants can pair up to discuss how they felt when they were
first diagnosed with breast cancer and strategies they used to cope
EXAMPLE
with their diagnosis.
If your group consists of health care professionals, they may pair
up to discuss how they feel when they have to notify a woman
that she has breast cancer and strategies they use to deal with
EXAMPLE
being the bearer of such devastating news.
Plan
29
· Triads (groups of three) are very useful for:
Getting everyone to think and participate actively; one
can be passive in a group of five, but that is unlikely in a
group of three
Testing out an idea one is hesitant to present to the full group
· Groups of four, five, or six will add a bit more variety for
sharing ideas and insights. Four, five, or six can be a good size
for a planning team, a film discussion group, or a more complex
situation.
However, the bigger the group becomes, the longer the discussion
and the decision-making process.
Dividing Groups and Assigning Roles
When facilitating an interactive training, it sometimes is necessary
to divide participants into groups and assign them roles. The
following are some imaginative ways to divide participants into
groups:
· Deck of cards--the four suits are the four groups
· Colored stickers or dots placed on or under chairs
· Different types of candy (e.g., peppermints, butterscotch,
cinnamon, or fruit flavors), which participants pick out of a
basket
· M&Ms of different colors
· If groups do not need to be exactly even, use things like types of
cars participants drive, types of toothpaste they use, preferences
for different types of music, etc.
Selecting a Group Recorder/Reporter
· Select any date at random; the person whose birthday is
closest to that date becomes the recorder
· Choose a person who lives closest (or farthest) from the
meeting site
· Choose the person newest (or oldest) to the organization
· Choose the person with the most pets (including fish)
· Choose the person who exercises the most
· Choose the person who watched the least TV in the past week
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TRAINER'S GUIDE FOR CANCER EDUCATION
Training Method #3: Brainstorming
Brainstorming is an activity that generates a list of ideas, thoughts,
or alternative solutions around a particular theme or topic.
Creative thinking is more important during this activity than
practical thinking. No idea is dismissed or criticized; anything
offered is written down. Often participants stimulate each
other's thinking.
After the list of ideas is completed, the group clarifies, categorizes,
or discusses one item at a time, depending on the situation. Some
examples related to cancer education include brainstorming all the
reasons teens start using tobacco or all the barriers to referrals for
clinical trial participation on the part of primary care physicians in
rural areas.
Uses
· Introduces a problem or question (e.g., "Let's brainstorm all the
reasons women might be reluctant to return for followup after an
abnormal pap result.")
· Forms the basis of discussion
· Can use in conjunction with group discussion
Advantages
· Generates ideas and leads to discussion quickly
· Allows everyone's ideas to be expressed and validated
without judgment
· Generates energy to move forward with problem solving
· Stimulates thought and creativity
Disadvantages
· Can be difficult to get participants to follow the rules of not
diminishing or criticizing the ideas generated during the
actual brainstorming activity
· Affords opportunity for participants to get off track and
develop a list too broad to guide discussion
· Opens up the possibility that participants may feel badly if
their idea meets with criticism
· Requires that participants have some background related
to the topic
Plan
31
Process
1. Establish the rules for brainstorming, including the following:
· All ideas will be accepted for the list
· At no time should an idea be discussed or criticized
· Discussion occurs only after the brainstorming session
is complete
2. Warm up the group by doing a "practice" exercise such as
having everyone write down on a piece of scrap paper
everything you can do with a rule--then go around the
room and generate a group list
3. Announce the cancer-related topic, problem, or question
4. Write the ideas and suggestions on a flipchart to prevent
repetition and keep participants focused on the topic
Note: It is helpful for your co-trainer to record the ideas while
you call forth the ideas from the group. If there is no co-trainer,
a trusted participant can function in this role. Be sure, however,
that the participant chosen for this recorder role can keep up
with a fast-paced generation of ideas. Nothing impedes the
brain-storming process more than a recorder who constantly
asks for ideas to be repeated, words to be spelled, or acronyms to
be explained.
5. Allow silence; give participants time to think
6. Provide positive feedback to encourage more input from
participants (i.e., say "These are great ideas...")
7. Review written ideas and suggestions periodically to
stimulate additional ideas
8. Conclude brainstorming when no one has any more ideas to
add to the list
9. Review the final list before discussion
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TRAINER'S GUIDE FOR CANCER EDUCATION
Variation
A variation to the method described above is to ask each
participant to write down his or her thoughts or ideas about the
topic on Post-it notes. The trainer then collects all the notes and
quickly organizes them into categories. The participant group
goes over the categories and responses under each one and
discusses the similarities, differences, consistencies, inconsistencies,
and take-home messages.
Plan
33
Training Method #4: Case Study
A case study is a written description of a hypothetical situation
that is used for analysis and discussion. It is a detailed account
of a real or hypothetical occurrence (or series of related events
involving a problem) that participants might encounter. It is
analyzed and discussed, and participants are often asked to arrive
at a plan of action to solve the problem. Case studies can help
group members learn to develop various alternative solutions to
a problem and may help develop analytical and problem solving
skills. Some cancer-related examples are illustrated below.
Uses
· Synthesizes training material
· Provides opportunity to discuss common problems in a
typical situation
· Provides a safe opportunity for developing problem
solving skills
· Promotes group discussion and group problem solving
Advantages
· Allows participants to relate to the situation
· Involves an element of mystery
· Avoids personal risks by using hypothetical situations
· Involves participants in an active manner
Disadvantages
· Requires a lot of planning time if you need to write case
studies yourself
· Requires careful design of discussion questions
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TRAINER'S GUIDE FOR CANCER EDUCATION
Process
1. Introduce the case study to participants
2. Give participants time to familiarize themselves with
the case
3. Present questions for discussion or the problem to be solved
4. Emphasize that there is not always only one right solution, if
appropriate for the specific case
5. Give participants time to solve the problems individually or
in small groups
6. Circulate among the small groups to:
· Clarify any questions participants may have
· Make sure that participants are on task
· Make sure that a few participants are not dominating
the discussion
7. Bring everyone back together for a larger group discussion
8. Invite participants to present their solutions or answers
9. Discuss all possible solutions or answers
10. Ask the participants what they have learned from
the exercise
11. Ask them how the case might be relevant to their own lives
12. Summarize the points made
Plan
35
Tips for Developing Case Studies
· Develop a case study that is as realistic as possible.
· Describe the people in the case study.
· Use names (but be sure to indicate that they are not the names of
real people).
· State their genders, ages, ethnicities, and other relevant
characteristics.
· Describe the specific situation.
· Think about the specific issues you want the participants to
address.
· Use the case study to challenge assumptions (e.g., health care
worker doesn't always know the answers, patients aren't always
uninformed).
· Avoid giving solutions to the problems raised in the case study.
· Avoid making the case study too complex or too simplistic.
Some examples of discussion questions that use the adult learning
cycle as a model include the following:
· Describe what you see and hear happening in this case study.
· What feelings does the case study evoke in you?
· What are the key issues that are brought to light by this
case study?
· What do you think are some of the underlying causes that lead
EXAMPLE
to these issues?
· What are some possible strategies for dealing with these issues?
· How can we each make a difference in addressing these issues?
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TRAINER'S GUIDE FOR CANCER EDUCATION
Example Case Study
You have been invited to conduct a training for home health
nurses on the topic of cancer pain management. You were
told that there are a number of issues that impede the use of
appropriate pain medication with cancer patients who are
followed by the home health agency. One of these in particular
involves nurses not feeling comfortable advocating with
physicians for their patients because of fear of addiction to
opiate derivatives.
During the training, a nurse participant, Suzanne, brings up a
recent article she read in the New York Times Magazine. The article
described the abuse of oxycontin in rural America. Suzanne says,
"There's no way I'm going to contribute to getting a whole
generation hooked on those things. I'm just trying to protect my
patients' grandkids by keeping those things (oxycontin pills) out
of the house." Another participant, Ellen, adds that most of her
"little old ladies" are too sensitive to medications to "get them
started on something that powerful." You realize that there are a
lot of passionate feelings about this topic and wonder how you
should handle the situation.
Case study questions for training participants to discuss:
· Describe what you see happening in this case study.
· What feelings does the case study evoke in you?
· How do you think Suzanne is feeling?
· How do you think Ellen is feeling?
· What do you think are the underlying issues behind each of
their responses?
· What are some effective ways you, as the trainer, could
handle this discussion?
· How will your discussion about this case study influence
how you might handle other difficult training discussions in the
future?
Plan
37
Training Method #5: Demonstration
A demonstration is a method for showing precisely how a skill,
task, or technique should be done. The trainer or a skilled
participant shows other participants how to successfully perform
a given task by demonstrating it, describing each step, and
explaining the reasons for performing it in a particular way. It is
often followed by a practice session in which the participants
carry out the activity under the supervision of the trainer. The use
of models or props (e.g., silicone breast models or fecal occult
blood collection kits) greatly enhances a training on self breast
exams or colorectal screening. Having simulated or standardized
patients for clinicians to practice new skills (e.g., performing
clinical breast or pelvic exams) leads to effective acquisition of
these new skills.
Uses
· Show participants how to perform a skill (e.g., showing
community members how to do a self breast exam or use the
collection kit for a fecal occult blood test)
· Clarifies and corrects misconceptions about how to
perform a task
· Shows how participants can improve or develop skills
· Models a step-by-step approach (e.g., how to do a clinical
breast exam using the vertical strip method)
Advantages
· Provides learning experience based on actual performance
and is relevant to the participant's job or personal experience,
especially when combined with hands-on practice
· Illustrates processes, ideas, and relationships in a clear and
direct manner
· Requires low development costs
· Helps participants' focus their attention
· Involves participants when they try the method themselves
Disadvantages
· Has limited usefulness
· Requires a lot of planning and practice ahead of time
· Requires facilities and seating arrangements that are carefully
planned so all members of the audience have an unobstructed
view of the demonstration
· Requires enough materials for everyone to try the skill being
demonstrated
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TRAINER'S GUIDE FOR CANCER EDUCATION
· Does not ensure that participants will immediately be able to
duplicate the skill being demonstrated after seeing it
demonstrated
· Requires that participants take passive role during
demonstrations which may cause them to lose interest,
particularly during afternoon hours and toward the end of
the session
Plan
39
Process
1. Introduce the skill being demonstrated: What is the purpose?
2. Present the materials that are going to be used
3. Demonstrate the skill for participants
4. Repeat the demonstration, explaining each step in detail
5. Invite the participants to ask questions
6. Allow participants to practice the skill themselves
7. Circulate around to each person to:
· Observe participants as they perform the skill
· Provide them with constructive feedback
8. Bring participants back to the larger group
9. Discuss how easy or difficult it was for them to perform
the skill
10. Summarize the take-home messages or key points
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TRAINER'S GUIDE FOR CANCER EDUCATION
Training Method #6: Role Play
Role play is a technique in which several individuals or a small
group of participants act out a real-life situation in front of the
group. The scenario of the role play is related to the training topic
and must have a skill-based objective. For example, in a training
on breast cancer for nursing students, two participants might role
play how to teach a woman how to do a self breast exam. There is
no script; however, the situation is described in as much detail as
appropriate. The participants make up their parts as the situation
unfolds. The role play is then discussed in relation to the situation
or problem under consideration.
Uses
· Helps change people's attitudes
· Enables people to see the consequences of their actions
· Provides examples of possible reactions or behaviors
· Provides a safe environment for exploring problems they may
feel uncomfortable discussing in real life
· Enables participants to explore alternative approaches to
various situations
· Explores possible solutions to emotion-laden problems
Advantages
· Provides opportunity for stimulating new ideas while
having fun
· Engages the group's attention
· Simulates the real world
· Provides a dramatic way of presenting a problem and
stimulating a discussion
· Allows participants to assume the personality of another
human being--to think and act as another might
Disadvantages
· Requires that participants feel comfortable being in front of a
group (some participants may feel self-conscious, shy, or may
fear looking "ridiculous")
· Requires dyads or triads in which everyone is either acting or
observing to address participant reluctance
Plan
41
Process
1. Prepare the actors so they understand their roles and the situation
2. Set the climate so the observers know what the situation involves
3. Observe the role play
4. Thank the actors and ask them how they feel about the role play (be
sure that they get out of their roles and back to their real selves)
5. Share the reactions and observations of the observers
6. Establish ground rules for having a group discussion about the role
play. For example:
· Make your comments in a self-oriented manner. Try to
express your feelings as you were watching the role play. For
example, "The interaction in the role play made me feel..."
· Make your comments descriptive of what happened. For
example, "I noticed that the woman had eye contact twice with
her friend."
· Try not to interpret the behavior of the players in terms of
EXAMPLE
why they did what they did. If this seems necessary,
however, ask the players in an open-ended way rather than
putting words into their mouths (e.g., "I was wondering why
you asked the woman her marital status.")
As a group leader, your attitude and direction in this discussion are important.
Try to protect the role players from too much exposure to negative comments. In
addition, try to get the observers to put their comments in the form of suggestions
on how to improve the handling of the situation. The best way to do this is to set
the example yourself. Attempt to be as nonevaluative as possible. Try to invite
people to talk freely about their own experiences. Then summarize the comments
given in relation to the learning points.
7. Discuss as a group the different reactions to what happened
8. Ask the participants what they have learned
9. Ask the participants how the situation relates to their own situation
10. Summarize the main messages or points and application
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TRAINER'S GUIDE FOR CANCER EDUCATION
Handling Participant Resistance
There might still be some resistance to role playing. Several types
of resistance you might encounter are presented below along with
suggestions on handling.
· Fear of exposure: This usually relates to a person's fear of being
exposed to the total group and acting as a fool. One way of
handling this is to use multiple role playing rather than single
role playing. Divide the group in pairs and ask them to do their
own role plays in different corners of the room. Using this
method, you should walk around to get a feel for how each
dyad is doing and whether the role play is being used the way it
was intended.
· What is going to happen to me? Generally this refers to a
person's fear of not knowing the procedures involved in role
playing. This may be related to lack of knowledge about the
topic or lack of role playing skill. Usually a good explanation of
the different steps in the session clarifies the issue. You should
ensure that people won't be criticized by acknowledging how
difficult role plays can be and thanking participants for their
bravery in being willing to step outside their comfort zone to
provide an excellent learning experience for everyone.
The most important thing in dealing with resistance seems to be
to allow it to be there, accepting the feelings and thoughts behind
it. But at the same time, you should try to be clear that you want
to do the role play and why. If you feel good about it, this will be
reflected by the group.
Plan
43
Role Play Example: A Woman with Colon Cancer Considering Clinical
Trials
You are Sonya, a woman just diagnosed with colon cancer. You
have no medical insurance. You are talking to Mary, the local
support group leader, about recommended treatment options.
You've heard about clinical trials, but you tell her, "I don't want to
be a guinea pig just because I'm poor."
You have heard about the Tuskegee study, in which African
American men with syphilis were studied for years without getting
treatment. You know that some of your neighbors get paid for
participating in asthma studies. You want the best treatment, but
you don't want to be treated poorly.
You want to know:
· What are clinical trials?
· Why can't I choose my treatment if I decide to be on a trial?
· What are the pros and cons of participating?
· Are they experimenting on people?
· How do I know I'm being protected?
EXAMPLE
You are Mary, a local community leader who runs a support group.
You want to assist Sonya by helping her understand
more about what clinical trials have to offer and refer her to
community resources. Talk with her using the following guidelines:
· Be sensitive to Sonya's concerns.
· Remember to provide information that is fact-based, not your
opinion.
· Provide resources and support.
During the discussion, you may wish to address the following:
· What clinical trials are
· How patients are protected
· Risks and benefits of participating
· Informed consent
· How to find out about clinical trials in the community that might
be appropriate
· Talking about this information with her doctor or nurse
· Talking with her family
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TRAINER'S GUIDE FOR CANCER EDUCATION
Training Method #7: Creative Work
Although some people believe that using the arts in training is
"touchy feely" and therefore not appropriate, others have found
that this approach is well received by many audiences. These
training activities give participants an opportunity to think or act
"outside the box." Examples of creative activities include:
· Making a collage (e.g., make a collage of ways you got support
when you were diagnosed with cervical cancer)
· Drawing or painting with markers, water colors, chalk, or
colored pencils (e.g., painting a picture of what fear of
recurrence looks like)
· Modeling with clay (e.g., making a sculpture of the body
post-mastectomy)
· Composing songs, poems, stories, or plays (e.g., writing a play
about teens who changed their peer group's norms related to
smoking tobacco)
Uses
· Encourages participants to engage the "right brain" (creative,
non-linear part), especially important after a "left brain"
training method (i.e., didactic or linear presentation)
· Explores other ways to think about familiar situations
· Enables participants to explore emotionally-laden topics in a
safe way
· Encourages people to move beyond their comfort zone
Advantages
· Gives participants an opportunity to have fun while dealing
with emotionally laden issues
· Allows participants to move around (especially good for
kinesthetic participants)
· Provides a creative way of dealing with sensitive issues
· Fosters interaction and emotional connections among
participants
Plan
45
Disadvantages
· Requires additional space and materials
· Intimidates participants who feel shy about artistic endeavors
(But don't assume that your audience won't respond well to
this technique. You might try out the idea with a few people
who are demographically matched to your potential
participants before your training session.)
· Causes participants who are used to linear thinking and
came to the training to get new information to question the
usefulness of this approach
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TRAINER'S GUIDE FOR CANCER EDUCATION
Process
1. Introduce the creative activity to participants
2. Discuss how the activity ties into the topics being covered
3. Provide participants the "permission" to take risks, be
creative, and not feel that they have to strive for perfection.
Sometimes asking people to remember what they were like in
the 5th grade will help them to be less inhibited and "let go"
of their inner critic
4. Assure participants that these activities are not intended to be
judged on artistic merit but rather to stimulate new ways of
thinking about the topic
5. Review the materials that are available to complete the
creative activity (e.g., clay, markers, magazines, scissors,
glue, etc.)
6. Tell participants how long they will have to work on their
creations (e.g., minimum of 30 minutes). Explain that you will
give them a 10-minute warning before they have to finish
their work
7. Provide the allotted time for participants to create
8. Circulate around the room to see how participants are doing
9. Give the 10-minute warning, as promised
10. Bring everyone back together for a larger group discussion
11. Discuss the ground rules for the discussion:
· Participants should support each other
· Comments made about another person's creation should
relate to how the creation makes them feel
· Comments should not be evaluative or judgmental
12. Invite individuals to share their creations and how they tie
into the topic
Plan
47
13. Ask participants to discuss both of the following:
· The process of creating
· The meaning behind their work
For example, in a group of breast cancer survivors, each
person would share her collage with the group and talk
about the images that were selected, the meaning behind
them, and how they relate to the support they got when
EXAMPLE
they were diagnosed with breast cancer. Then they would
talk about how it felt to create the collage.
14. Summarize the discussion
15. Affirm participant's work and ability to be creative
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TRAINER'S GUIDE FOR CANCER EDUCATION
3. Choosing Audiovisual Materials
Audiovisual materials are essential to effective instruction.
The primary purposes of training media are to support the
explanations (by illustrating, demonstrating, and emphasizing)
and to provide motivation (by increasing sensory appeal, adding
variety to the instructional approach, saving time, and retaining
participant interest). They can be used to increase knowledge and
change attitudes.
Characteristics of Effective Training Media
They should be:
· Simple (easy to understand, uncomplicated)
· Accurate (facts and figures, current information)
· Manageable (easy to operate and manipulate, simple, neat, and
practical)
· Colorful (use color to emphasize main points)
· Necessary (illustrate essential materials, contribute to successful
accomplishment of learning objectives)
When Selecting Training Media
· Use your training objectives to determine where audiovisual
materials are needed to assist participant learning.
· Be selective. Remember that a few good training media will do
more for the achievement of objectives than will many confusing
ones.
· Update and improve your use of training media or develop new
ones for more effective participant learning.
· Consider the enhanced visual/verbal relationship that different
media can create. The objective is to maintain visual simplicity
and verbal clarity for maximum retention of information.
· Remember that dark rooms can put participants to sleep
especially after a meal. Keep the area as well lit as possible while
ensuring participants can see the words on the screen.
· Maximize the use of media by following slides, videos, audiotapes,
and photos with a targeted discussion. Consider the following
format as one useful way to move participants from description, to
feelings, insights, and action steps:
Plan
49
Describe what you see and hear happening in
this video.
What feelings does the video evoke in you?
What are the key issues that are brought to light by this
video?
What do you think are some of the underlying causes that
lead to these issues?
What are some possible strategies for dealing with these
issues?
How can we each make a difference in addressing these
issues?
Main Types of Training Media
· Handouts
· Flipcharts and flipchart paper
· Overhead transparencies and projector
· Computer-generated presentations (e.g., PowerPoint) using
computers and LCD projectors or 35 mm slides
and projectors
· Videotapes and tape player
Each will be discussed in this section.
Handouts
Handouts are supplementary materials that provide a detailed
expansion or reiteration of one or more aspects of the presentation.
Hints:
· Handouts can be your worst distraction during a presentation if
distributed while you are speaking. Whenever possible, provide
handouts at the end of a presentation unless the audience will
use them during the training. In that case, provide the handouts
before the presentation to avoid distraction.
· Reduced-size reproductions of charts or slides used during the
presentation can be extremely useful to participants as reference
material. Adding brief interpretive statements can remind
participants of your key points at a later date.
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TRAINER'S GUIDE FOR CANCER EDUCATION
Flipcharts
· A flipchart pad can provide flexibility for developing and
modifying simple sketches, diagrams, and statements during the
course of a presentation.
· Color is extremely important. Green, blue, and brown should be
used primarily for words. Avoid visuals that are one color. Use
red, orange, or yellow for highlighting only. If you have five- or
six-line visuals, use colors to separate them or to group them.
Hints:
· Maintain the flow of your talk while you write.
· Avoid talking to the board.
· Stay to the side while writing on a flipchart pad.
· Write large and neatly.
· Draw a faint outline of a diagram or model in pencil before the
presentation to provide guidelines for the marker or chalk.
· Limit the number of words to avoid pages that are too "busy"
and thus distracting.
· If you prefer, have a co-trainer or participant write while you
facilitate group discussion.
Overhead Projector
An overhead projector is used to project material from a book or a
prepared transparency onto a screen.
Hints for designing transparencies:
· Do not use more than four of five words per line. Keep in mind
that the area that can be projected is only 7.5" x 9.5".
· Do not crowd too many lines onto a transparency.
· Design it so it can be read from the back row of the training
room.
· Use dark letters on light backgrounds.
Hints for using overhead projectors:
· Place a transparency on the projector before the training in order
to focus it.
· Always have a spare light bulb (in case the one provided with
the overhead projector burns out) and extension cord with you.
· Designate someone to control the room lights.
Plan
51
Slides, LCD Projectors, and Computers
(for computer-generated presentations)
Slides are still the most common visual aid used in training.
However, many health care professionals are switching to LCD
projectors and computers to project computerized presentations
onto a screen. The following information applies to both slides
and PowerPoint presentations.
Hints for designing slides or a computer-generated presentation
(e.g., PowerPoint):
· Keep each screen simple with bullet points and simple visuals.
Each bullet point can be elaborated during the presentation.
· Use large enough font (30 point) so that the text can be read
from the back row of the training room.
· Use colors and designs that are pleasant, but not distracting for
the viewer.
· Use colors that make text stand out on a slide. Use a light color
for the text on a dark colored background (pale yellow on dark
blue is best). The more color used, the less effective it will be.
· Use visual aids that complement the text.
· Use uniform font.
· No more that 75 percent of each slide should have text.
· Use animation (on PowerPoint presentations) sparingly. While it
is interesting to have bullet points appear or cross the screen as
you read them, too much animation can be distracting.
Hints for using slides:
· Make sure your slides are placed in the carousel so they
project right side up.
· Practice showing your slides before the training.
· Practice using the remote control for changing slides.
· Practice operating the electronic pointer if you will be using one
during your presentation.
· Always have a spare bulb and an extension cord with you.
· Designate someone to control the room lights.
Hints for using an LCD projector and computer:
· If you do not have your own slide projector or LCD and
portable computer, reserve one for your training.
· Make sure the computer is equipped with compatible software
to run your presentation (e.g., does the computer have
PowerPoint?).
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TRAINER'S GUIDE FOR CANCER EDUCATION
· Make sure that your presentation fits onto a diskette, or put it
on a Zip Disk. If a Zip Disk is needed, you will need a portable
Zip Drive.
· Before the training, do a test run of your presentation to assure
that there are no problems using your disk in the computer.
· ALWAYS BRING A COPY OF YOUR PRESENTATION ON
OVERHEADS--JUST IN CASE!
Examples
Examples of good and bad slides from computer presentations
follow:
Bad Example
Ways to Prevent Skin Cancer
· Font too small
· Too many
Stay out of the sun between 10:00 a.m. and 4:00 p.m. unless
words on the
you are adequately protected.
Wear sunscreen that is 15 SPF or higher. Make sure
slide/screen
that the sunscreen has not expired. Reapply sunscreen
· Not visually
several times thoughout the day.
Be sure to wear long-sleeved shirts, long pants, wide-
pleasing
brimmed hats, and sunglasses.
Talk with your friends and family members about sun
protection. Remind them to stay away from the midday
sun, use sunscreen, and wear full coverage clothing.
It is best to combine these strategies to make sure that
you are getting full prevention from the sun and
decrease your chances of developing skin cancer.
Good Example
ABCs of Decreasing Skin Cancer Risk
· Large enough
font (at least
30 point) the
Away--Stay away from the midday sun
slide/screen
· Visually
Block--Use 15 SPF or higher sun block
pleasing
Cover-up--Wear full coverage clothing
Use a combination of these strategies
Plan
53
Videotape Players
Because the videotape player is extremely versatile, it is rapidly
becoming a major tool in presentations.
Hints for using videotape players:
· Use is limited for large groups (i.e., more than 20 participants)
because multiple monitors or large video projection screens are
needed.
· Most equipment is portable but cumbersome.
· Compatibility of the type and size of the videotape and cassette
to the available equipment should be carefully considered.
· Have tapes set at the proper starting point so that only
the PLAY button needs to be pushed.
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TRAINER'S GUIDE FOR CANCER EDUCATION
4. Crafting a Realistic and Effective
Training Plan
Once you are clear about the characteristics of the participants and
the training goals and objectives, you can design a realistic and
effective training plan.
It is important to consider not only what you hope to achieve in
terms of changes in knowledge, attitudes, and skills, but also the
sequence of various training activities and information. There
should be a good balance between didactic and interactive
activities, between acquiring new knowledge and skills, and
having an opportunity to synthesize and apply new information
and behaviors. Most trainers design trainings that are too packed
with activities and information. While it is important to have
additional activities that can be used if needed, it is essential to
remember that participants will retain more if given opportunities
to reflect, synthesize, and practice new insights and skills. Some
guidelines to follow include the following:
Vary Activities
Change the type of activity approximately every 30 minutes (e.g., if
you just gave a 20-minute lecturette on a new cervical cancer
screening policy, give participants an opportunity to discuss in small
groups the implications of this policy on their client base or have
participants apply this new information to a prepared case study).
· Intersperse didactic activities such as lecturing and
demonstrations with more participatory ones such as small
group exercises, individual work, role plays, and a variety of
other training strategies.
· Vary learning activities to appeal to all types of participants.
· Structure activities to go from simple to complex concepts; from
EXAMPLE
safe to more risk-taking activities.
· Include activities that encourage real-life problem solving.
· Include opportunities for application and practice.
Set Realistic Goals for the Training
· Choose information or skills that participants need to know; not
information that would be nice to know.
· Think about your learning objectives (developed in section II.1)
Plan
55
and develop your take-home messages to correspond with them.
· Remember that three to five take-home messages are the most
people can retain in a one-day training.
· Match objectives to training and evaluation methods. For
example, didactic or lecture methods can lead to knowledge
change but probably not attitude change or skill acquisition.
Interactive methods can lead to change in knowledge and
attitudes. Demonstrations and practice can reinforce skill
acquisition.
· Think about how you will evaluate the training.
Be Aware of Time Management Issues
· Build in time for movement from one activity to another. This is
especially important if small group breakouts take place in a
different room from the main meeting room.
· Build in time for forming small groups.
· Build in some "slush" time to make up for a late start, getting
behind schedule because of lengthy discussion, dealing with
unforeseen circumstances (e.g., fire drill), or other time
challenges.
· Build in time for breaks. Give participants a break no less
frequently than every 90 minutes.
Prepare a Clear Training Plan
The level of detail with which a training plan is written depends
on a number of factors:
· Is the person who is designing the training plan the same person
who will conduct the training?
If the training plan is going to be used solely by the person
writing it and is a one-time event, then it can be more of an
outline with bulleted "talking points" and places to jot down
examples.
· Will there be a co-trainer or others who will need to use the
training plan?
If the training plan is going to be used by more than one
person, it needs to be very detailed and explicit.
Is the training a one-time event or will it be offered a number
of times? If the training will be offered on an on-going basis, it
may be helpful to have more detailed notes to avoid
"re-creating" the details each time the training is conducted.
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TRAINER'S GUIDE FOR CANCER EDUCATION
Whether you or another person will be conducting the training, it
is extremely important that all directions for activities be explicitly
written as well as examples of questions to be used to process or
discuss the activities. The suggested time allotment for each
activity should also be clearly stated as well as the materials
needed to conduct all the activities. This level of detail will
ultimately make your life easier and will ensure a smoother
training program.
A "Sample Training Plan Template" and a "Training Plan
Worksheet" are located in appendix B. A sample training plan
follows on the next few pages. For this sample,
The left column contains:
The right column contains:
· Plenty of blank space so you
· Detailed instructions for
can jot down your own
what to do and say
notes
· Description of how to use
· A list of training materials
any training materials that
that are needed for each
are needed for each portion
portion of the training
of the training
· An estimate of how much
· Lists of possible answers to
time it will take to complete
questions posed to
each portion of the training
participants during the
training session
· Text in italics indicates things
for the trainer to say to
participants
Plan
57
Sample Training Plan
Time and materials
Task
Trainer instructions
60 minutes
Set up room and
q Arrive early to set up the room.
familiarize self with
q Make sure there are enough
location
chairs and that they are arranged
in a circle (around a table) to
facilitate participation and
discussion.
q Organize handouts, training
materials, and visuals (e.g.,
breast models, mammography
films).
q Locate lights.
q Set up and test audiovisual
equipment.
q Put out refreshments, candies,
etc.
q Put out a sign-in sheet and
name tags.
q Make the room more
comfortable and enjoyable
(tablecloths, decorations, music, etc.).
q Locate restrooms, telephones,
and water fountains.
10 minutes
Participant arrival and
As participants arrive:
sign-in
q Ask participants to write their
q Sign-in
names on sign-in sheet.
sheet
q Ask participants to write their
names on a name tag.
q Drinks and
q Offer drinks and light
refreshments
refreshments.
q Welcome participants and thank
them for taking time to
participate in this training.
q Reassure them that we are going
to have fun while we learn
about breast cancer early
detection measures.
q Review "housekeeping" details
such as the location of
restrooms, telephones, and
water fountains.
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TRAINER'S GUIDE FOR CANCER EDUCATION
Time and materials
Task
Trainer instructions
5 minutes
Welcome and introduction
q Welcome and make brief
introductions.
q Prepared flipchart
q Refer to flipchart with agenda.
Agenda
Explain that we have a lot to
cover, but hopefully it will be
q Prepared flipchart
interesting and engaging.
Goal and objectives of
q Refer to flipchart with goal and
training
objectives of the training.
Explain that the goal of this
training is to:
· Increase understanding about
the importance of breast
cancer early detection
q Explain that the objectives of this
training. By the end of this training
participants will be able to:
· Demonstrate steps involved
with making an appointment
for a mammogram
· List at least three barriers
women may face to obtaining a
mammogram and suggestions
on how these barriers can be
addressed by health care
organizations.
· Describe American Cancer
Society recommendations for
mammography screening.
· Demonstrate commitment to
increasing awareness about
the need for mammography
screening by telling at least
four friends to schedule a
mammogram in the next month.
15 minutes
Icebreaker
q Explain that we will be doing a
lot of work together today so it's
important to know a little about
each other.
q Give instructions for the ice-
breaker:
· In a roundtable format, ask
participants to say their name,
what they know about why
they were given their name
(e.g., named after great aunt),
or what it means (e.g., the
name Athena is the Greek
word for "light").
· Ask the women if they think
their name fits their personality.
Plan
59
Time and materials
Task
Trainer instructions
5 minutes
Group discussion and
q Explain to participants that setting
group norms (this will be
"norms" or ground rules for the
q Prepared flipchart
covered in more detail in
training will help make the training a
Norms
section III. 1.)
safe, respectful, and comfortable
environment for everyone to learn
and share.
q Refer to flipchart with norms listed
on it. Review each norm and give a
brief explanation.
· I'd like to share with you some norms
other groups have found useful.
q Ask if anyone has additional ground
rules to add.
q Post the ground rules on the wall to
serve as a visual reminder.
15 minutes
Group brainstorm:
q Explain to participants that studies
barriers women may face
have shown that many women face
q Blank flipchart paper
to obtaining a
several barriers to obtaining a
mammogram
mammogram.
q Colored markers
q Ask the participants to brainstorm a
list of barriers women may face.
q Review the rules of brainstorming
with participants. That is, that during
the actual brainstorming of ideas,
nobody should criticize any ideas
that others suggest. Ideas will be
discussed only after the brainstorm-
ing session is completed.
q Using a blank flipchart paper, write
down the barriers participants
suggest.
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TRAINER'S GUIDE FOR CANCER EDUCATION
Time and materials
Task
Trainer instructions
15 minutes
Group brainstorm:
Some examples of barriers women may
barriers women may face
face include:
q Blank flipchart paper
to obtaining a
· Lack of insurance to cover
mammogram (continued)
mammogram
q Colored markers
· Lack of transportation to the
appointment
· Lack of childcare during the
appointment
· Difficulty in taking time off work for
appointment
· Embarrassed to disrobe in front of
the provider
· Fear that the mammogram will hurt
· Fear of finding breast cancer
· Fear that having a mammogram
means that the woman has no
faith in God
q When the participants are
finished brainstorming the list
of barriers, add the barriers that
may have been missed.
q Read through the list out loud,
getting rid of duplicate answers
or grouping similar types of
barriers suggested.
q Explain that in the next portion
of the training, participants will
work in small groups to discuss
ways that health care
organizations can address these
barriers so that more women
will be able to obtain
mammography screening.
Plan
61
III.
Implement
III. Implement
1. Creating a Safe and
Comfortable Learning Environment
Adults learn best when the training environment is emotionally
safe and physically comfortable. There are a number of
different strategies trainers can employ in order to create a
positive learning environment.
Setting Up: Ensuring a Comfortable Room Ambiance
Adults learn best in a pleasant environment where their
physical needs are met. If possible, when selecting a room
make sure there are adequate measures for controlling the
temperature. Rooms that have windows that provide natural
lighting and contact with the outside world are preferable.
Beware of the following conditions that may distract from the
training session:
· Windows that provide outside noise or visual distractions
such as people walking by or nature scenes
· Inadequate facilities (uncomfortable chairs, no tables to write
on, inadequate lighting, and poor acoustics). Note: For large
groups a microphone may be needed. A lavaliere microphone
will allow the trainer to move freely around the room.
Sometimes it is difficult to control room conditions. Simply
acknowledge to the participants that you are sorry for the
discomfort and state what you can and cannot control.
Enhancing the Room
Even the drabbest meeting room can be made more pleasing
through the use of decorations. Bring in posters that pertain to
your topic, wall hangings, flowers, tablecloths, and candles.
Use colorful markers when writing flipcharts.
Setting Up the Room with Chairs
How the room is set up will greatly affect participant
interaction. Four common room arrangements and their
benefits and drawbacks are described below.
Implement
63
Room Set-up
Benefits
Drawbacks
Circle Seating
· Stimulates interaction
· Visual aids difficult to
· Promotes more equal
use
X
X
role between trainer
· More difficult if large
X
and group members
number of participants
X
· No room to write;
materials must be
X
X
balanced on laps
X
X
"U" Shape Seating
· Leader more easily
· Participants at
becomes a part of
extremes may be
X
group
distant from each
X
X
· Facilitates
other--may hamper
X
X
communication
communication
· Takes time to arrange
X
X
furniture
X
X
X
X
X
Workshop Clusters
· Good freedom for
· Takes lots of space
participants
· Visuals can be difficult
X
· Good discussion and
to see
X
X
X
X
diverse communication
· Lots of participant
X
X
working space
X
· Can accommodate
large groups
X
X
Standard Classroom Seating
· Easy to set up/rented
· Participants cannot
facilities often set up
easily talk with or see
X
this way
one another
· Can accommodate
· Leader clearly apart
large groups
from the group
X
X
X
· Visuals may be difficult
to see
X
X
X
= Trainer
X
X
= Participants
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TRAINER'S GUIDE FOR CANCER EDUCATION
Getting Started
Once the training room is set up, you are ready to welcome
participants to the training. As participants enter the training
room, welcome them, ask them to sign in, give them name tags
and any training materials or handouts for note taking, and
remind them of the starting time. Start the training as close to the
scheduled time as possible to signal respect for participants' time.
Help Participants Know What to Expect
Emotional safety is essential in creating a positive learning
environment. For participants to feel comfortable in a new
training situation they need to know what to expect from the
training and what is expected of them as participants. The trainer
should review the following with participants:
· The goals and objectives of the training
· An overview of the agenda including:
Stop and start times
Times for breaks and meals (if appropriate)
· The trainer's role (i.e., a facilitator rather than a speaker
or presenter)
· The participants' roles (i.e., active contributors to the group
discussions and activities). The trainer should emphasize that
the participants have a lot of wisdom to share with the group
and that everyone will be greatly enriched if people participate
fully in the training activities
· Where they can take care of their basic needs [e.g., location of
restrooms, telephones, and places to obtain food and drink (if
not provided by the training)]
Learn About Participants` Strengths and Needs
See page 12 for conducting a needs assessment at the beginning of
a training if not done before.
Create Ground Rules
Ground rules (also called group norms) are guidelines that help
create a safe environment and enable tasks to be accomplished
efficiently. Examples of ground rules include:
· Honor everyone's input regardless of educational degrees,
professional or community status, or personal experiences with
the topic
· Value each person's unique opinions and perspectives
· Agree to disagree, but do so respectfully
· Speak one-at-a-time
Implement
65
· Allow each person time to talk
· Start and end on time; come back from breaks promptly
· Keep personal comments said during the training confidential
· Support those who may have anxiety talking about emotionally
difficult topics
· Step outside your comfort zone
· Speak for yourself, not other people (i.e., use "I" statements
rather than "everybody" or "other people")
· Take charge of your own learning (i.e., take breaks when you
feel necessary, ask for clarification)
· Have fun even though the topic is a serious one
· Ask questions
· Feel free to "pass" when discussing a certain topic
It is preferable for a training group to develop their own ground
rules that reflect what is important for them to feel safe. However,
if there is limited time, the trainer can suggest a set of ground
rules and then ask the group for any additional ones. For example,
in professional audiences it may be important to add the ground
rule "put all cell phones and pagers on vibrate or turn them off." The
trainer should address any participant concerns about the ground
rules and then ask for people to follow these throughout the
training. Tape the list of ground rules on the wall so all
participants can see them. Refer to them if necessary during the
training.
Create a "Parking Lot"
Explain to participants that the parking lot is a place to put
questions, comments, or concerns that are important but slightly
off the topic currently being discussed. Assure them that
everything placed in the parking lot will be addressed by the end
of the training (and keep your word, revisiting the parking lot as
appropriate throughout the training).
After the trainer has "set the stage" for how the group will move
through the training together, she or he can then move into the
icebreaker or warm-up activities. Section III.3. describes these in
more detail.
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2. Facilitating the Training Experience
As a trainer, your goal is to help participants learn new
information and build skills. The best way to help people learn is
to use facilitation techniques that recognize and build on the
knowledge, skills, and experiences they already have.
All of the training methods that were discussed in section II. 2.
will be greatly enhanced through the use of good facilitation
skills. For some of you, the following information is undoubtedly
a review. However, even the most experienced trainers may find a
few new ideas or strategies to add to their trainer's tool kit. This
section is divided into three parts. The first part covers general
guidelines of facilitation and the second part describes effective
strategies for working with multicultural training groups. The
third part addresses additional considerations.
Implement
67
Part 1. General Guidelines for Facilitation
Encouraging Group Participation
When participants take an active role in their learning, they are
more likely to "own" the information and skills covered in the
training. People are more likely to participate actively in the
training session if you do the following:
· Maintain relaxed body language.
· Use an icebreaker to help participants relax, get to know each
other, and get ready to learn. (Specific examples of some
icebreakers are described in appendix A)
· Set group norms (sometimes called ground rules) to help make the
training a safe, comfortable, and productive learning environment.
· Ask participants to give examples to illustrate a point. This
strategy ensures that examples are relevant to participants.
· Bounce back to the group questions you receive from
participants, as appropriate. "What do other people think about
this?" and "What other ideas do you have?" are ways to show
participants that you recognize their expertise.
· Show participants that you appreciate their contributions by
saying things such as, "That's a good point," "Thank you for
bringing that up," or "Many people have that same question."
· Link discussion back to comments participants made earlier in
the session (e.g., "As Monique (or we) said earlier, this is a very
emotionally charged subject.")
· Bridge forward to what comes next (e.g., "After break we're going
to practice putting these new insights into action!")
· Move around. If you stand behind a podium, you are likely to
appear distant or inaccessible to participants.
Open-ended Questions
Whenever possible, ask questions instead of talking "at"
participants. You can do this by asking open-ended questions--
questions that cannot be answered with a simple "yes" or "no."
These questions usually begin with words like "where," "when,"
"what," and "how." The word "why" can be used if it is said in a
questioning way rather than a confrontational way. For example,
asking, "Why do you think some people are reluctant to get a
EXAMPLE
colonoscopy?" would be appropriate, but asking, "Why aren't you
getting regular screenings?" might be seen as confrontational.
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Open-ended questions can be used early in a training to get a
sense of participants' expectations and baseline knowledge levels.
Open-ended questions send the message that participants' input is
welcome.
You also can use open-ended questions to review information
already covered. For example, you could have participants review
or summarize parts of the training by asking the following
questions:
· "What new information have you learned?"
· "How will you apply what you have learned today to your
EXAMPLE
personal health behaviors?"
In addition, you can use open-ended questions to help
participants share ideas, experiences, barriers, and solutions when
you process activities or discuss content. Examples of these types
of questions include the following:
· "What has been your experience in finding information about
cancer clinical trials?"
· "What are some of the barriers you may face in encouraging
your mothers to get mammograms?"
EXAMPLE
· "How can you overcome the barriers you have identified?"
Open-ended questions are a simple way for trainers to
acknowledge that participants have valuable information and
experience to share. However, using open-ended questions often
takes longer than lecturing. If you find that you are running out of
time in a session, you may need to limit responses from
participants (e.g., "We have time for one or two more comments.").
Active Listening
Active listening skills can help participants feel like their ideas are
truly an important part of the training experience. In addition,
active listening helps the trainers understand participants'
concerns. This greater understanding helps you tailor the training
to better meet their needs. An effective, active listener uses both
verbal and nonverbal skills to acknowledge participation, clarify
information, and encourage dialog.
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Verbal active listening skills include:
· Repeating what participants say to emphasize their points
· Rephrasing participants' words to see if you understand what
they are saying
· Connecting participants' points to something covered earlier in
the training
EXAMPLE
· Asking for clarification if you are not sure what participants
mean
· Thanking participants for their contribution
Nonverbal active listening skills include:
· Maintaining open, receptive body language
· Making eye contact with the speaker
· Leaning forward
EXAMPLE
· Nodding when appropriate
Managing Time
Time management can be one of the most challenging aspects of
conducting a training session. It takes a skilled trainer to cover
content in a way that involves and engages participants within a
limited timeframe. Some ways to manage time effectively are:
· Make clear that participants and trainers will be expected to
respect starting, ending, and break times.
· Help participants who wander off the topic to tie in their
comments with the discussion at hand.
· Ask participants' permission to "table" questions, suggestions,
or comments.
EXAMPLE
· Limit comments on any given topic. (Always encourage
participants to continue their dialog on breaks or after the
training session.)
If you run into a situation in which you have too little time to
cover all topics on the agenda, you may need to negotiate with
participants about what they most want to cover. By allowing
them to identify what is most useful to them, you make the most
of the time remaining and meet participants' needs.
Giving Feedback
As noted above, it is important to give positive feedback to
participants throughout the training. In addition, it may be
necessary to give corrective feedback at several points in the
training, as you help participants build their skills and
knowledge.
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TRAINER'S GUIDE FOR CANCER EDUCATION
Effective corrective feedback, which is always given in a
supportive manner helps participants improve. Tips for giving
corrective feedback include the following:
· Focus your comments on the participant's behavior rather than
on the individual.
· Always point out something the participant did well.
EXAMPLE
· Point out something specific the participant could improve on.
Corrective feedback is never a personal attack on an individual;
it is always offered as a way of helping someone increase
knowledge or improve skills.
"Checking In" with Participants
A good trainer is able to read the body language of the
participants to ascertain the appropriateness of the training
content, the pace of the training, and the energy level in the
group. This can be done informally on an individual basis during
breaks or more formally with the entire group. Asking questions
such as "How's everyone doing?" (and allowing time for honest
responses) or asking people to summarize the key points from a
particular segment of the training will help trainers assess
whether participants are grasping new information. Mid-training
adjustments may need to be made if it appears that many of the
participants have not understood the material, appear bored, or
need additional help with concepts or skills.
Trainer observations during role plays, demonstrations, or small
group activities can provide assessments of how well new
material is understood and integrated. For example, if after
teaching a group of women how to do a self breast exam, you
notice that people are performing it incorrectly during a practice
session, you can review and reinforce the correct method. Be
careful not to put all of your focus on the one or two "challenging
participant(s)" to gauge how the entire group is responding to the
training (discussed in detail below).
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Working with Challenging Participants
In most training groups there are a couple of participants who pose some challenges
to a smooth and effective training process. The table below summarizes some of
these challenges.
Types of
Why are they
Ways to work effectively
challenging
challenging?
with this type of participant
participants
"Know it alls"
· May actually have a
· Acknowledge that they are a
lot of information about
wealth of information.
the topic but
· Approach them during a break
still could benefit from
and ask for their assistance in
the experiences and
answering a specific question.
perspectives of others
At the same time, express your
concern that you want to
encourage everyone to
participate and enlist his or her
help in doing so.
"I'm only here
· May have been
· Acknowledge that you know
because I have
required to attend the
that some of the participants are
to be"
workshop, yet has no
present because they have to be.
particular personal
· Ask for their assistance in making
interest in the topic
this a meaningful experience.
· Ask specifically "How can I make
this workshop helpful to you?"
"Nay Sayers"
· May be prejudiced
· Don't put them down or make
· Won't accept your or
them feel isolated. Keep them
other participant's point
involved, if possible.
of view
· Throw their views to the group
by questions or examples. Try
to get the group to bring
them around.
· Say that time is short and you
would be glad to discuss their
issues with them individually.
· Ask them to accept the views of
the group or the trainer for the
moment.
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TRAINER'S GUIDE FOR CANCER EDUCATION
Types of
Why are they
Ways to work effectively
challenging
challenging?
with this type of participant
participants
"Talkers"
· May be "eager
· Don't be embarrassing or sarcastic; you
beavers" or show-offs
may need their help later.
· May be exceptionally
· Slow them down with some difficult
well informed and
questions or difficult tasks (such as
anxious to show it, or
group leader).
just naturally wordy
· Interrupt tactfully with something like:
· May need to be
"That's an interesting point...
"heard"because they
now let's see what the rest of the group
are still working
thinks of it."
through difficult
· In general, let the group take care of
emotional issues
them as much as possible.
· May take time
· Avoid eye contact.
away from other
· Give them a role.
participants
· State that your role is to keep people
on time.
· Quick interruption--move to them and
put your hand on his or her shoulder.
· Paraphrase what they say and move on.
· Acknowledge that their stories are
important and you and others would
love to hear them later or after the
workshop.
"Questioners" · May be genuinely
· Acknowledge that they seem to have
curious
a lot of questions about a particular
· May be "testing" you
topic.
by putting you on
· If the questions seem like legitimate
the spot
attempts to gain content information
· May have an opinion
(which other members of the group
but not confident
already know), tell them that you will
enough to express it
be happy to work with them later to fill
in the gaps or put the question on the
parking lot.
· Reframe or refocus. Send the
questions back to the questioner.
· Establish a buddy system (i.e., ask for
volunteers who would be willing to
meet with them).
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Types of
Why are they
Ways to work effectively
challenging
challenging?
with this type of participant
participants
"Arguers"
· Have combative
· Keep your own temper firmly in
personalities
check. Don't let the group get
· May not want to be at
excited either.
the workshop
· Honestly try to find merit in one of
· May be upset by
their points (or get the group to do
personal/family
it) then move on to something else.
health issues
"That was a good point" or "We've
· May upset other
heard a lot from [person's name], who
participants
else has some ideas?"
· If facts are misstated, ask the
group for their thoughts; let them
turn it down.
· As a last resort, talk with them in
private, find out what's going on,
and ask for cooperation. For
example: say, "Let's talk at break/end
of session. How can we be on the same
team?"
· Give them a role.
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TRAINER'S GUIDE FOR CANCER EDUCATION
Part 2. Strategies for Working Effectively with
Multicultural Training Groups
Ensuring Cultural Sensitivity
To be effective, trainers must be aware of cultural issues that can
affect the training environment. Culture can influence people's
values, attitudes, beliefs, and behavior, and therefore has an
impact on how people learn, communicate, make decisions, and
interact in groups.
Many people think of culture simply as a person's race or
ethnicity. However, culture includes many different aspects of
people's lives. That is, people's cultural background may be
influenced by their:
· Race/ethnicity
· Gender
· Regional differences
· Language
· Sexual orientation
· Level of formal education
· Profession or job
· Spiritual beliefs and practices
· Physical ability
· Age
When you work with multicultural groups, keep in mind that
although people from a specific cultural group may share
common traits, all members of a cultural group are not alike.
Individuals within cultural groups have their own personal
experiences, personality traits, values, and belief systems. It is
therefore important to respond to a person's needs and not
assume that the person will respond in a certain way because she
or he belongs to a particular cultural group.
For those of you who train health professionals, keep in mind that
there is a "culture of medicine." People who work in health care
have a common language and view of health and illness. These
views may or may not be shared by community and patient
groups. Therefore, when training audiences that are made up of
both health professionals and others who do not work in health
care, make sure that acronyms, medical jargon, or other abstract
concepts are not used unless they are well explained. Also, it will
be important to be alert for biases and assumptions that health
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75
professionals may share but which may conflict with community
members' cultural values, attitudes, and beliefs.
Considering Power Differentials
In training groups where participants might come from diverse
backgrounds or positions of power, be alert for ways that power
imbalances might affect the training. For example, if you are
training a group of health professionals, some may be supervisors
of others in the room. The "supervisee" might feel awkward
about sharing certain feelings or revealing a lack of skill or
knowledge related to the topic with his or her supervisor in the
room. Likewise, patients may feel awkward discussing health
EXAMPLE
care concerns if their nurse, physician, or social worker is in the
same audience.
Some tips for dealing with power differentials within an audience
are the following:
· Acknowledge that the situation exists.
· Emphasize that each person's unique perspective and
experience is equally valued and refer to other ground rules that
address issues such as these.
· Avoid participant introductions that emphasize academic
degrees or professional status. Instead ask people to describe
their connection to the topic.
· Lay advocates might need to pair with a health care
professional "buddy" when addressing professional audiences so
that they can learn what the expected protocol for training these
groups is (e.g., Do the professionals want a personal story or a
PowerPoint presentation?).
Self-awareness
To fully appreciate cultural power and differences, trainers must:
· Recognize their own culture's influence on how they think and
act.
· Understand the complexities of cross-cultural interactions and fully
appreciate, value, and respect participants' diversity.
· Be aware of the impact of institutional and societal racism,
sexism, ageism, and other such "-isms," and acknowledge how
these forms of oppression can influence group dynamics.
· Share appropriate personal experiences from one's "own"
culture while not attempting to be an expert on other cultural
groups.
· Be aware of their own power within the group and use that
power appropriately (i.e., acknowledge that everyone in the
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TRAINER'S GUIDE FOR CANCER EDUCATION
room has something important to share and that you, as the
trainer, hope to learn from the group).
Cross-cultural Communication
To improve cross-cultural communication skills, trainers should:
· Avoid statements based on stereotypes. If generalizations are
used, they should be clearly labeled as such and modified with
terms such as "many" or "some."
· Appreciate the different ways that people from various cultures
engage in group discussions. Silence, for example, has a
different meaning, depending on personal experience and
cultural background.
· Ensure that all participants have an opportunity to express their
ideas to the group during discussions.
· Remember that participants have different levels of proficiency
in reading, writing, speaking, and understanding the language
used in a training session.
Finally, even with all cultural considerations in mind, there is no
substitute for exercising good common sense and judgment in
considering how, what, and when to address various issues in a
training. Almost any training activity has the potential to be
culturally offensive when facilitated by someone who does not
demonstrate respect for participants. Demonstrating respect for
participants is crucial and opens the door for mutual growth and
learning.
Body Language and Movements
Trainers also must be aware of the different ways people share
information. In addition to talking, people use body language,
physical contact, and body movements to express themselves.
Be aware that the appropriateness of physical space, touching,
physical contact, and eye contact can vary depending on cultural
norms, personal experiences, and personal preferences.
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Part 3. Other Considerations
Other considerations on training facilitation:
· Training team composition sends a message. Whenever possible,
trainers' cultural backgrounds should be representative of
participants' backgrounds. Diverse groups of participants will
benefit from seeing people from their own communities among
the trainers. In addition, a multicultural training team models
cooperation and sharing among cultures.
· Trainer styles differ, just as learning styles do; therefore, be
careful in designing the training on the basis of an individual
trainer's preferred style.
· Acknowledge areas of weakness and expertise. If given a direct
question, make an attempt to answer it in an accurate and
forthright manner. If you do not know the answer, admit it. If
you can get back to the questioner with the correct answer at a
later date, do so.
· Keep training goals and objectives in mind at all times, but
especially when processing. Be aware of participants who might
take over or seek to control. If you are uncomfortable with
conflict, or uncertain about how to address it, seek training in
conflict resolution. Conflict inevitably occurs whenever two or
more people come together, so be prepared.
Review the Characteristics of Effective Trainers
Those who are conducting cancer education training programs
need to posses certain skills to be effective. Consider using the
"Trainer Skills Checklist" located in appendix B to assess your
owns strengths and needs.
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TRAINER'S GUIDE FOR CANCER EDUCATION
3. Using Icebreakers and Energizers
In addition to the training methods discussed in section II.2,
icebreakers and energizers are important parts of participatory
trainings.
Icebreakers
Icebreakers can be a good way to start your training. They
warm-up participants, put them at ease, get people involved, and
open up communication. Icebreakers create a positive learning
climate within the group. They foster interaction, build group
identity, stimulate creative thinking, acquaint participants with
each other, and help establish comfort.
Considerations for selecting an icebreaker:
· Think about the group with whom you are working.
· Consider participants` ages, cultural backgrounds, educational
levels, occupations, and personalities.
· The length of the icebreaker depends on the length of the
training. More time can be devoted to icebreakers when the
training is a full day or longer.
· Icebreakers should make people feel comfortable. Do not use an
icebreaker which would embarrass someone, or at which people
would fail. Use an icebreaker that makes you feel comfortable,
not one that raises anxiety.
· Choose icebreakers that encourage everyone to speak. This is
especially important for shy or timid participants. Once their
voice is "in the room," shy participants are more likely to
contribute to subsequent discussions.
· Icebreakers are best when they are related to the topic of the
training. However, sometimes it is important to have a "fun"
icebreaker not related to the topic to lighten the mood or create a
comfortable environment!
Examples of icebreakers are found in appendix A of this trainer`s
guide.
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Energizers
Energizers can be used at anytime during a training when the
energy or attention of the participants is low. Energizers should
take no more than 5-10 minutes. They are really intended to get
people up and moving--not to spend a long time discussing
ideas. They are especially helpful right after a meal when people
are often sluggish.
Introduce energizers with enthusiasm since some participants
may be reluctant to "act silly." Model the activity first and be an
active participant yourself. This gives participants "permission" to
get involved, too.
Examples of energizers are found in appendix A.
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4. Conducting Closing Activities
Close the Training
It is important to close a training. Often this step is overlooked
due to time constraints. In addition, some trainers feel that the
evaluation serves as the closing activity. However, closings are
different from conducting an evaluation of the program. They
provide a way to summarize or "wrap-up" the training content as
well as an opportunity to "close out" the emotional aspects. Done
well, they help participants draw a boundary between the
training and the rest of their lives and prepare them for the
reentry process.
Put Closure on the Content of the Training
Participants should experience a sense of closure with regard to
the content of the training. Some examples of ways to do this are
listed below:
· Ask for a volunteer to summarize the key take-home messages.
· Conduct games that review concepts or information learned
during the training.
· Do a post-test.
· Develop an action plan describing how the participant will use
the new knowledge, attitudes, or skills.
EXAMPLE
· Review expectations from the beginning of the training and ask
if all have been met. Answer any lingering questions or
concerns.
Trainings where there has been a lot of personal sharing or where
participants have formed strong emotional bonds need closure so
that participants are not left with unfinished feelings.
Put Closure on the Emotional Component of the Training
Examples of ways to put some closure on the emotions that were
generated by the training include the following:
· Take a group photo.
· Have participants stand in a circle and say one thing they have
appreciated about the other participants. A variation is to have
people write comments on small pieces of paper and put their
EXAMPLE
contributions in cups marked with each participant`s name. This
strategy works best when participants have been together over a
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81
2- to 3-day training or part of a group that meets over several
months.
· Give participants an opportunity to plan a reunion or another
time to get back together (again, this is most appropriate for
groups that have met over time or where deep bonding has
EXAMPLE
occurred).
· Give certificates of participation or completion.
· Give gifts or incentives as a way to thank people for their time.
An example of a closing statement is located in appendix A.
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TRAINER'S GUIDE FOR CANCER EDUCATION
5. Evaluating the Training
It is important to give participants an opportunity to give
feedback about the content of the training, the trainer(s), and the
logistics of the training. There are a number of ways trainings can
be evaluated--some more formal and some less formal. Ideally
the evaluation should relate back to the training goals and
objectives. Choose an evaluation strategy that will be most
appropriate for your audience. While health care professionals
might be familiar with Likert type scales, diverse community
groups might prefer a less structured approach. The sample
evaluations that follow range from a more structured, quantitative
approach to a very informal, qualitative instrument.
Many trainers feel that it is important to wait at least some
amount of time before looking at training evaluations. Right after
a training you may feel somewhat vulnerable so try to wait until
the next day, at the earliest, to review the evaluations. When
reading the evaluations, remember that feedback is a gift. Most
gifts come from well-intentioned people but not all of them are
"on target." Read each evaluation carefully, then review them for
themes. Trainers learn most from the reactions of the majority of
the participants rather than focusing on one or two comments.
Although "outlier" comments can be helpful, most often they say
more about the participants than about the trainer or training. If
you are using a quantitative or Likert scale evaluation form, enter
them into a database if you have one and then review the average
scores for each item. If you are using a qualitative evaluation tool,
summarize participant comments and reactions.
Finally, in order for evaluations to be most useful, trainers need to
develop an action plan for incorporating useful feedback into
future trainings.
Examples of training evaluations can be found in appendix A.
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IV.
Summary
and
Conclusion
IV. Summary and Conclusion
Comparison of Training Elements for Three Audiences
For each training you conduct, you will need to plan Assessment, Goals/Objectives,
Training Strategies, Use of Training Media, Icebreakers, Energizers, Evaluation, and a
Closing Activity. The chart below summarizes much of the information contained in
this guide, and how it applies to running trainings for different audiences.
Patients/Survivors
General
Health
Community
Professionals
(People not already involved
in cancer as a patient or
family member)
Assessment
·
·
Focus group
Focus group
· E-mail survey
·
·
In-person
Phone or
· Fax-back survey
interviews (e.g.,
in-person
· Phone or
intercept
interviews
in-person
interviews at
interviews with
malls)
key people
Objectives
All seven types may be appropriate according to training goals
Training
·
·
Role plays
Role plays
· Lectures
Strategies
·
·
Small group
Small group
· Case study
discussions
discussions
· Demonstrations
·
·
Creative
Creative
· Small group
strategies
strategies
discussions
·
·
Case studies
Case studies
·
·
Demonstrations
Demonstrations
Note: Role plays
·
·
Lecturettes
Lecturettes
and other creative
endeavors might
be appropriate for
certain topics
Use of
·
·
Flipchart
Flipchart
· PowerPoint
Training Media
·
·
Overhead
Overhead
· Slides
·
·
Video
Video
· Video
Summary and Conclusion
85
Patients/Survivors
General
Health
Community
Professionals
(People not already involved
in cancer as a patient or
family member)
Icebreakers
· Exercises that
· Exercises that
· Brief
introduce the
encourage
introductions
workshop topic
sharing
· Focused on topic
of workshop
Energizers
· Fun
· Fun
· Focused on
stretching, but
not activities
that may be
perceived as
"silly"
Evaluation
· Qualitative tools
· Qualitative tools
· Likert,
· Quantitative and
· Quantitative and
quantitative tools
qualitative com-
qualitative com-
· Qualitative tools
bined for lower-
bined for lower-
literacy tools may
literacy tools may
be appropriate
be appropriate
Closing Activity
· What I appreciate
· What I appreciate · Action plan
about others
about others
· What I learned
· What I learned
· What I'll do
differently as a
result of this
workshop
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Reference
List
97
Reference List
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De Mauro, D., & Patierno, C. (1990). Communication strategies for
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Appendix
A
101
Example #1
Icebreaker -- Paired Interviews
Purpose
To help participants get acquainted with their fellow participants
and practice their interview skills
Time
Depends on number of participants. Allow 1 to 2 minutes per
participant
Group Size
No more than 20 for one large group; can divide large groups into
smaller ones but then everyone would not hear all the
introductions
Materials
Scrap paper and pens/pencils for participants to jot down notes
Directions
1. Pass out postcards or playing cards that are cut in half.
2. Instruct participants to find the person who has the other half
of their card. (This gets people up and moving around.)
3. When all pairs have matched up, ask them to take turns
interviewing each other. Each person will have four minutes to
learn the following things about his or her partner:
· Name
· How they spend their day (e.g., job or other responsibility like
caretaking for a sick spouse)
· Their interest in or connection to the training topic
· One hope for the training
· One interesting thing about them (e.g., hobbies)
4. Tell participants that they will be introducing their partner to
the entire group when it reconvenes, so they may want to take
notes.
5. After 4 minutes, give participants a signal to change partners.
6. At end of 8 minutes (or after each person has had a chance to be
an interviewer and be interviewed), call large group back
together.
Appendix A
89
7. Start the introductions by modeling a succinct introduction of
her/his co-trainer.
8. If some participants give lengthy introductions, remind the
group that time is limited and it is important to hear from
everyone.
9. Assure participants that they will have other opportunities at
breaks and meals to network.
10. Thank participants for their introductions.
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TRAINER'S GUIDE FOR CANCER EDUCATION
Example #2
Icebreaker -- Go-Rounds
Purpose
To give participants a chance to learn something about their
fellow participants and to encourage everyone to speak out
Time
One minute per person
Group Size
No more than 20 for one large group; can divide into small groups
but then everyone would not hear all the introductions
Materials
None
Directions
1. State the purpose of the exercise and ask each person to say his
or her name followed by the answer to one of the following
questions:
· What is one thing you'd do if you were given $100,000 with
no strings attached?
· What is one thing you'd like to change about the world (or
about cancer care, education, or screening)?
· Describe a strong feeling you've had in the past week and a
reason for that feeling.
· What is one thing you'd like to get from the training?
2. Post the questions on a flipchart paper or overhead so
participants can focus on the discussion and not on
remembering the question.
Appendix A
91
Example #1
Energizer -- Beach Ball Toss
Purpose
To review material learned from a previous session or determine
what participants would like during the current session
Time
5-10 minutes
Group Size
No more than 2025 participants
Materials
Choice of using either a beach ball, Nerf ball, or Koosh ball
Directions
1. Instruct participants to form a circle.
2. Explain that you will throw the ball to someone within the
circle. When that person catches the ball, he or she should
mention a key message or concept heard during a previous
session.* Once he or she has made a statement, he or she
should toss the ball to another person within the circle.
3. Ask participants not to toss the ball to the person on their
immediate left or right.
4. Suggest that participants should step out of the circle once they
have participated.
5. Continue tossing the ball until all participants have had an
opportunity to participate.
*Note: If this is the first session for the training program, ask
person to tell you what he or she expects to learn.
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Example #2
Energizer -- That's Me
Purpose
To get participants moving, i.e., standing up and down; it also
allows participants to get acquainted with each other
Time
5-10 minutes
Group Size
Unlimited
Materials
None
Directions
1. Give the following directions:
· You will ask a question, such as "Who has grandchildren?"
· If that characteristic "fits," participants will stand up, raise both
arms outstretched over their head, and shout,
"That's Me!"
2. Ask the group to practice standing up and shouting
"That's Me!" when you count to three.
3. Ask the group as many of the following questions (or questions
of your choice) as time allows. Mix in questions that are more
personal with those that pertain to the topic of the training.
· Who lives in (this state)?
· Who traveled more than 4 hours to get here?
· Who has grandchildren?
· Who exercised this morning?
· Who took a vacation last summer?
· Who ate at least one serving of fruit this morning?
· Who had a clinical breast exam within the last year?
· Who watched at least one movie or videotape in the last month?
· Who plans to shop while in (this city)?
· Who knows someone who has been on a cancer clinical trial?
· Who has a pet?
· Who has read a nonfiction book in the last 3 months?
· Who is eager to learn more about (the topic)?
Appendix A
93
Example
Closing Activities --
Closing Statements and Handout
Some activities serve to close out both the emotional aspect and
content of the training. This exercise is an example of one that
serves both purposes.
Purpose
To give every participant a chance to summarize their experience
of the training in a way that the group can share
Time
10-15 minutes
Group Size
Up to 20 participants
Materials
Closing statement handout for each participant
Directions
Ask participants to:
1. Take a Closing Statements Handout (see below).
2. Take a minute to complete any of the sentences on the handout
that they choose (give participants 5-10 minutes to complete
handout).
3. Form a circle in (the back of the room).
4. Ask participants to go around the circle and share one of the
closing statements out loud.
Notes to Facilitator
· You can place this before or after the evaluation, but don't hurry
it. Give people a sense of how much longer you plan to keep
them (i.e., "We'll do this exercise for 10 minutes, spend 5 minutes
finishing evaluation forms, and then we'll adjourn").
· Be sure participants will be able to see and hear each other.
· Don't respond to what is shared; model respectful, quiet
acceptance of what's offered.
· End by thanking everyone for sharing the training with you.
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Closing Statements Handout
Please complete any of these sentences to summarize your
experience of this training event. You will be asked to share one
with the group.
I learned..._________________________________________________
___________________________________________________________
___________________________________________________________
I feel...____________________________________________________
___________________________________________________________
___________________________________________________________
I was surprised...___________________________________________
___________________________________________________________
___________________________________________________________
I'm wondering...____________________________________________
___________________________________________________________
___________________________________________________________
I've re-discovered..._________________________________________
___________________________________________________________
___________________________________________________________
I figured out...______________________________________________
___________________________________________________________
___________________________________________________________
I appreciated..._____________________________________________
___________________________________________________________
___________________________________________________________
I felt challenged...___________________________________________
___________________________________________________________
___________________________________________________________
I'm clearer about...__________________________________________
___________________________________________________________
___________________________________________________________
Appendix A
95
Example #1
Training Evaluations -- Form (Version A)
Name (Optional) ___________________________________________
Were the overall program goals met?__________________________________
__________________________________________________________________
__________________________________________________________________
Goal 1: The overall goal/purpose of the training is to provide health
education coordinators with the knowledge and skills to plan,
implement, and evaluate effective outreach strategies for
increasing the number of adults aged 50 years and older who get
colorectal screening at appropriate intervals.
r Yes
r No
Goal 2: A second goal is to provide health education coordinators with
the knowledge and skills to provide tips for training peers to
conduct effective outreach for colorectal screening.
r Yes
r No
If no, please explain and give suggestions for improvement:
1. What are the top three things you learned from this training?___________
__________________________________________________________________
__________________________________________________________________
2. If you could give the trainers one piece of advice on how to improve the
training, what would it be?________________________________________
__________________________________________________________________
__________________________________________________________________
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3. What were some of the training's highlights or parts that you valued
most? __________________________________________________________
__________________________________________________________________
__________________________________________________________________
4. What did you like least about the training? __________________________
__________________________________________________________________
__________________________________________________________________
5. What other types of training would you like? ________________________
__________________________________________________________________
__________________________________________________________________
6. What problems or dissatisfaction did you have with the way the program
was scheduled? __________________________________________________
__________________________________________________________________
__________________________________________________________________
Appendix A
97
Example #2
Training Evaluations -- Form (Version B)
Circle the appropriate response.
1. Trainer organized the material effectively.
Strongly Agree
Agree
Neutral/
Disagree
Strongly
No Opinion
Disagree
Comments:
2. Trainer managed discussions effectively.
Strongly Agree
Agree
Neutral/
Disagree
Strongly
No Opinion
Disagree
Comments:
3. Trainer used effective teaching methods.
Strongly Agree
Agree
Neutral/
Disagree
Strongly
No Opinion
Disagree
Comments:
4. Trainer used handouts and audiovisuals that were appropriate and
contributed to the presentation.
Strongly Agree
Agree
Neutral/
Disagree
Strongly
No Opinion
Disagree
Comments:
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5. Discussion materials were clear.
Strongly Agree
Agree
Neutral/
Disagree
Strongly
No Opinion
Disagree
Comments:
6. The training can be applied to my current job.
Strongly Agree
Agree
Neutral/
Disagree
Strongly
No Opinion
Disagree
Comments:
7. The material presented is useful on a personal level.
Strongly Agree
Agree
Neutral/
Disagree
Strongly
No Opinion
Disagree
Comments:
8. The material presented is useful on a professional level.
Strongly Agree
Agree
Neutral/
Disagree
Strongly
No Opinion
Disagree
Comments:
9. Would you be interested in attending a followup session on this
topic?
r Yes
r No
If yes, specify the areas that you would like to see included in the agenda.
Appendix A
99
Example #3
Training Evaluations --
Feedback Cards Exercise
Purpose
To provide a mechanism for participants to give feedback regarding the
training/learning experience
Time
5-10 minutes
Group Size
Any size
Materials
Two colors of 3" x 5" index cards, enough for each participant to receive
one card of each color
Directions
1. Pass around two stacks of 3" x 5" index cards. Each stack
should be a different color (best to use colors that are easily
distinguishable from each other, e.g., blue and yellow).
2. Ask each participant to take one card of each color.
3. Ask each participant to write, "One thing you really liked or appreciated
about this training (or this day of training) on the ____ color card."
4. Ask participants to write, "One thing you wished had been different about
this training (or this day of training) on the ___ (other than in step #3) color
card."
5. When all participants have completed the cards, ask that they pass both
cards to the front.
6. Thank participants for their input and assure participants that the
trainers will carefully consider their feedback.
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Example #4
Training Evaluations --
Head, Heart, and Feet Exercise
Purpose
To evaluate the session at its conclusion, especially useful for
audiences with limited literacy skills
Time
15 minutes
Group Size
Any size
Materials
Evaluation sheet for each participant, flipchart, markers, and tape
Directions
1. Hand out the evaluation sheet that follows. Explain its objective
and how the information will be used.
2. Invite participants to use the markers to draw their head, heart,
and feet on the paper.
3. Ask participants to fill in the form (individually or with
someone else).
4. If there is time, ask them to share something they learned or to
give final comments.
Variation
Draw a large head, heart, and feet on flipchart paper and post it.
Distribute small slips of paper and ask participants to write down
the major things they learned or got out of the event. Post these
points in the appropriate position on the flipchart and discuss
them.
Appendix A
101
EVALUATION SHEET
Head: What did you learn today?
Heart: How did today's training feel to you?
Feet: What are you going to do as a result of the training today?
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Example #5
Training Evaluations -- Faces Exercise
Please circle the face that best describes your feelings about each
given training activity:
Icebreaker
Lecturette on risk factors
Values clarification exercise
Small group exercise on barriers and facilitators
Video
Energizer
Role play exercise
Appendix A
103
Appendix
B
119
Worksheet #1
Trainer Skills Checklist
Think about your own skills as a trainer then read through the
following statements.
· Put a check beside all of the statements you feel describe your
strengths.
· Circle the box beside the statements that describe areas where
you'd like to improve. Think about one or two things you could
do to build on your strengths to address areas that need
improvement.
r You know yourself. You are confident and fully prepared. You
are just nervous enough to keep alert.
r You know your subject matter. You have studied your topic and
have experienced the events about which you speak.
r You know your audience. You respect and listen to the
participants. You call them by name, if possible.
r You are neutral and non-judgmental. You validate everyone's
experience and their right to individual perspectives. You
respect differences of opinion and lifestyle.
r You are culturally sensitive. You are aware that your own views
and beliefs are shaped by your cultural background just as your
participants' cultures shapes their perspectives.
r You are self-aware. You recognize your own biases and
"hot-buttons" and act in a professional manner when your
"hot-buttons" are pushed.
r You are inclusive. You encourage all participants to share their
experiences and contribute to the group learning process.
r You are lively, enthusiastic, and original. You use humor,
contrasts, metaphors, and suspense. You keep your listeners
interested and challenge their thinking.
r You use a variety of vocal qualities. You vary your pitch,
speaking rate, and volume. You avoid monotones.
r You use your body well. Your body posture, gestures, and facial
expressions are natural and meaningful, reinforcing your subject
matter.
r You make your remarks clear and easy to remember. You
present one idea at a time and show relationships between
ideas. You summarize when necessary.
Appendix B
105
r You enhance with illustrations. You use examples, charts,
visuals, and audio aids to illustrate your subject matter.
r You understand group dynamics, and the stages all groups go through.
You are comfortable with conflict resolution.
r You are flexible. You read and interpret your participants' responses--
verbal and nonverbal--and adapt your plans to meet their needs. You
are in charge without being overly controlling.
r You are open to new ideas and perspectives. You are aware that you
don't know all the answers. You recognize that you can learn from
participants as well as offer them new knowledge or perspectives.
r You are compassionate. You understand that much of the
material may have an emotional impact on the participants. You are
empathetic and understanding about participants' emotional reactions.
r You are interested in evaluating your work. You encourage
co-trainers and participants to give feedback.
Describe one or two steps you can take to improve your skills as a trainer:
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
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Worksheet #2
Training Assessment Worksheet
This worksheet will help you conduct a needs assessment for each training you
are planning.
· What information do you need in order to design an effective training?
(Logistics, content, format, etc.)
· What do participants already know about the topic?
· What experiences or insights related to the topic do participants
already possess?
· What do participants believe are the challenges or barriers related to the
issue? (For example, why do they think people do not avail themselves
of colorectal screening services?)
· What do participants hope to gain from the training? (This includes
new knowledge, skills, resources, etc.)
· What do participants desire regarding the logistics of the training?
r Location of training
r Length of program
r Optimal number of days of training
r Best day of week
r Time of day
· Which is the most effective assessment strategy for your audience?
r E-mail survey
r Fax-back survey
r Mail survey
r Telephone survey
r In-person interview
r Focus group
r Review of previous training evaluations
Appendix B
107
Worksheet #3
Questions to Help Define Appropriate
Training Plan, Goals, and Objectives
This worksheet will help you prepare your plan, goals, and objectives for each
training you are planning.
Who are your participants?
· What is their educational level? _____________________________________
· What is their experience and skill level? ______________________________
· What gender and age are they? _____________________________________
· Are they employed? ______________________________________________
· What kind of work do they do? _____________________________________
· Do they work together? r Yes r No
· What is their literacy level _________________________________________
· How many will there be? (approximately) ___________________________
When will you conduct the training?
· What day of the week? ____________________________________________
· What time of day? ________________________________________________
· What time of the year? ____________________________________________
· How long will the session be? ______________________________________
· What will be the length of the entire program? ________________________
· How much time is there for recruitment? _____________________________
Where will you conduct the training?
What is needed?
· What size room is needed? _________________________________________
· What equipment is available? ______________________________________
· What other supplies are needed? ___________________________________
Location
· Is the location accessible? r Yes r No
· Is the location easy to find? r Yes r No
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· Can it be reached by public transportation? r Yes r No
· Is there safe parking? r Yes r No
· Is it handicap accessible? r Yes r No
· Is it a place that does not have negative connotations for
intended participants? (e.g., some places are associated with
poor service or indigent care which may make some
participants uncomfortable) r Yes r No
What will the training involve?
· What will be the content of the training plan?
___________________________________________________________
· What training tools will be needed?
___________________________________________________________
___________________________________________________________
· What participant materials and resources will be needed?
___________________________________________________________
___________________________________________________________
· Will there be advance work for participants?
r Yes
r No
What is the purpose of the training?
· What changes in knowledge, attitudes, behaviors, and skills are
you hoping to accomplish through the training?
___________________________________________________________
___________________________________________________________
· What are the goals and objectives of the training?
___________________________________________________________
___________________________________________________________
Appendix B
109
How will you do it?
· How will you enroll people for the training? (Some possible
recruitment strategies include flyers, PSAs on TV and radio, ads
in newspapers and newsletters, and word of mouth.)
___________________________________________________________
___________________________________________________________
· How will you engage participants?
___________________________________________________________
___________________________________________________________
· How will you get feedback or evaluate the effectiveness of your
training?
___________________________________________________________
___________________________________________________________
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Worksheet #4
Sample Training Plan Template
Time and materials
Task
Trainer instructions
Appendix B
111
Time and materials
Task
Trainer instructions
TRAINER'S GUIDE FOR CANCER EDUCATION
112
Worksheet #5
Training Plan Worksheet
This worksheet will help you plan a training.
Goal:
Objectives
What content is
What strategies are
How much time
needed to meet the
needed to deliver the
should be allotted
"At the end of
objectives
content (list 1 strategy)
each strategy
the workshop
and regulate the
participants should
energy flow
be able to..."
(icebreakers,
energizers)
· List at least 3
· Barriers specific to
· Brainstorming list of
· 20 minutes
barriers women
Pap tests on part of
barriers
may face in
the individual
· Reading focus group
· 15 minutes
obtaining a
woman
quotes from women
Pap test
· Barriers specific to
in the community
EXAMPLE
the health care
organization
Worksheet for your training:
Appendix B
113
Worksheet #6
Developing Appropriate Goals
and Objectives Worksheet
The goal for my training is:___________________________________
___________________________________________________________
The changes I want to see as a result of my training are:
r Increase in knowledge:_____________________________________
___________________________________________________________
___________________________________________________________
r Newly acquired skills:______________________________________
___________________________________________________________
___________________________________________________________
r Changed attitudes (e.g., more compassionate, etc.):_____________
___________________________________________________________
___________________________________________________________
r Increased proficiency in existing skills:________________________
___________________________________________________________
___________________________________________________________
Based on the above, the most appropriate objectives for my
training are:
(Please feel free to use verbs located on page 20 for guidance)
r
r
r
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Notes
115
This booklet was written and published by the National Cancer Institute (NCI), 9000
Rockville Pike, Bethesda, Maryland 20892.
NCI is the U.S. Government's main agency for cancer research and information about
cancer. To inquire about copyright and use of NCI materials contact: Clearance Officer,
National Cancer Institute.
Public Health Service
National Institutes of Health
NIH Publication No. 02-5052
Printed October 2001
P935