Preparation of

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Preparation of Expert Patient-Trainers for
the WHO Basic ART Clinical Training
Course and the ART Aid Training
Course     Benon Tumwebaze
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WHO ARE EXPERT PATIENTS

• These are patients with long-term health
  conditions and are able to take control and
  management of their conditions thus leading to a
  meaningful and productive life.
• Such conditions include diabetes, epilepsy,
  asthma, mellitus, Arthritis and now HIV etc.

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EPT IN IMAI CONTEXT

• These are people living with HIV and AIDS
  (PHA) who are trained to facilitate in the IMAI
  training through role playing HIV cases, related
  to specific learning objectives and giving life
  testimonies in group sessions.
• They present cases based on the principles of
  chronic HIV, PMTCT and TB basic care, with ARV
  therapy module.

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EPT SELECTION CRITERIA

• HIV positive and possibly on ART
• Able to write, read, speak and understand the
  language used for training.
• Motivated and committed to being part of the
  training team
• Willing to use their own health history in
  presenting cases
• Able to work within the ground rules and terms
  of the contract
•  

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EPT Training

• EPT undergo a 3 days training which exposes them
  to the general principles of good chronic care,
  good communication skills, the 5As (Assess,
  Advise, Agree, Assist, Arrange) and how to
  simulate HIV cases accurately.
• They are also trained in the basics of HIV and
  AIDS prevention, care, treatment and support,
  positive living, and how to give a constructive
  and non-judgmental feedback using a standardised
  tool (Checklist).

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ROLE OF EPT

• To role play the clinical cases exactly as they
  have been trained to ensure consistence.
• To ensure that service providers stick to the
  information related to the case being role
  played.
• To help service providers to work on
  communication and problem solving skills
• To give service providers a timely feedback from
  a patients perspective

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Class Facilitation (specific objectives)

• EPT Skills Station
• -Clinical role-play practicing the specific
  objectives
• Communication
• -         Problem solving skills
• -  Timely feedback

       
                       
                 
Facilitators meeting Review progress in class and
Skills station exposure
                 

• Card Sorts
• -         - Emphasis on specific objectives
• -         Further discussion

Class Review - Review what was done in skills
station and further highlight objectives
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Checklist
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CARDS SORT
Match the picture with the clinical stage
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• Skill station schedule

 
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CHALLENGES

• Language barrier as the training materials are
  printed in English.
• EPT work overload since in many cases the numbers
  in clinical teams out number EPTs.
• The EPTs are not part of the clinical teams so
  their resource remains untapped.
• Harmonizing the perceptions of patients and
  service providers

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LESSONS LEARNT

•  EPT cases were consistently the most popular
  part of the IMAI training courses in every
  country
• PHA feel valued and more involved and get
  pleasure from giving something back
• EPT Training helps in problem solving and
  formation of patient- service provider
  partnership
• The daily debriefing sessions help the EPT and
  health workers to improve their performance.

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PLANS FOR THE FUTURE

• Retrain the EPTs as ART Aide to support health
  facilities in
• Triage
• ART adherence support
• Group education on positive living
• Pre-test and post-test counseling
• Records management
• Disclosure of HIV status partner testing
  fighting stigma and discrimination,
• Mobilization of peers for ART, TB, and malaria
  services

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Thank you for your Attention