Date of Report: 2003 Source: Pacific AETC
Overview Level I Primarily didactic presentations, but can also include: panel discussions, self-instructional materials, journal clubs, teleconferences, etc. Participants are often passive learners, with programs varying in length from brief lectures to conferences. Level II Interactive and skills-building activities characterized by active trainee participation. These training activities may include interactive learning through discussion of cases supplied by trainer, role play, simulated patients, and train the trainer and other skill building activities. (Formerly Level II and some Level IIIA activities) Level III Training that includes activities where the trainee is actively involved with actual clinical care experiences involving patients. These may include preceptorships, "mini-residencies," or observation of clinical care at either the AETC training site or the trainee's worksite. Level IV Training that includes patient-specific clinical consultation provided to health care professionals. Characteristics of this level of training are: 1) interaction between two clinicians, 2) training initiated by trainee/topic selected by trainee and based on a patient-specific clinical question, 3) discussion of state of the art clinical care, 4) communication via telephone, electronic media, or in person on-site at trainee location, 5) no direct contact between patient and trainer, 6) interaction supported financially or administratively by AETC funds. These training activities may include clinical consultation, case based discussion with cases supplied by trainee, or clinical consultation on-site at trainee's clinical setting. Level V Technical assistance offered by the local performance site. Summary Table| | LEVEL I DIDACTIC PRESENTATION | LEVEL II SKILLS-BUILDING WORKSHOPS | LEVEL III CLINICAL TRAINING | LEVEL IV CLINICAL CONSULTATION | LEVEL V TECHNICAL ASSISTANCE | | Training Objective | Change in knowledgeLimited attitudinal change | Change in attitudes & skills | Change in knowledge, attitude & clinical skillsComfort & confidence to make sound/appropriate clinical decisions | Change in clinical problem-solvingChange in clinical decision-making for better or more appropriate careImpart state of art knowledge on specific HIV care | Provide resources, guidance & assistance to improve HIV service delivery & performance on an organizational levelChanging organizational infrastructure & service delivery | | Method of Training | Didactic knowledge transferJournal Club | Small group interactive sessionsWorkshopsRole playInstructor generated (hypothetical) case discussionUse of standardized/simulated patient care | Clinical observation of patient careInteraction with patients in care settingMini-residencyPreceptorship | Interaction between clinical consultant & clinical consultee (1-to-1 or multiple consultees)Patient-specific question & problem-solving via phone, Internet, fax or on-siteTelemedicine | Consultation style that is either organization- or AETC-drivenFocus on organizational or programmatic issues about HIV service delivery | | Role of Learner | Passive | Interactive with instructor & other participants in skills building activities | Interactive with patient. Facility within clinical setting. | Provider-driven | Active involvement at the organizational level | Duration (minimum) | 1 hour | 1 hour | 1 day | Distance consult: 5 minutes | Distance consult: 5 minutes to less than 1 hour | Duration (typical) | | 2 to 4 hours | 2 to 5 days | Distance consult: Less than 1 hourOnsite consult: 1 hour to several days | Distance consult: series of phone calls totaling 20 minutes to 1 hourOnsite consult: 2 hours to half-day to 2 days |
|