Training programmes for THPs must use learning methods that are effective considering the educational background, the cultural values and the learning styles of adults. These methods may be somewhat different for training THPs than for modern health workers. In general, the use of participative non-formal adult education methods has been found to work well with programmes that have trained THPs.
Experience has shown that THPs are extremely eager to learn and that they learn quickly when knowledge is presented in meaningful ways. Even though many have not had much formal education, this need not be a barrier to their learning. Respect healers who have difficulty reading or writing - they are just as intelligent and capable of learning as others. They are rich in life experience but did not have the opportunity to learn how to read and write when they were younger.
Use a variety of methods that involve the trainees. For instance, if trainees are to acquire skills in identifying problems and in decision-making, it is better to give a brief talk, and have them work on a case-study or to practice role-playing than to give them lectures. Role-playing is also useful to improve communication skills and behaviour.
Make learning as active as possible. Draw on the experience and communication skills of the students. Keep asking them what they already know and what they might do in certain situations.
There are a number of ways to create experiential learning situations:
• ask questions to stimulate people to think and to give responses;
• divide people into small groups and give them an assignment to do together, such as a problem to solve;
• break them into groups of twos or threes to discuss a topic or dialogue together;
• do a role-play in front of the group;
• demonstrate a topic and involve the class in it;
• simulate a real life situation and have students act it out;
• have students observe clinic procedures and then practise the techniques on each other.
The following are frequently used training methods and will be described in some detail. These methods are relatively easy to use, do not require extensive resources and preparation, and have all been used effectively to train THPs.
Giving a talk
Most teachers feel comfortable giving a talk to students. This is the customary way people learn in a classroom setting. Though lecturing is not the most effective way to help THPs learn, there are many times when a short talk is a convenient way to give information to a group, as long as it is combined or followed with some form of participation from trainees.
Talks are useful to give specific information, to reach a number of people at one time, and to introduce a new or unfamiliar topic.
How to prepare an effective talk
• Decide what the trainees need to learn.
• Gather information from your own experience and from books and manuals.
• From this information choose what the trainees need to know.
• Arrange the material in a logical way. Study it until you are familiar with it.
• Decide how much time you will spend on each point. Don't try to cover too much material in one talk. It is better to make two short presentations rather than one long one.
• Write an outline of what you are going to say.
• Plan the questions you will ask, and the visual aids you will use.
• Use simple language. Communicate what you mean. Don't try to impress trainees with your knowledge.
• Speak loudly and clearly, but in a friendly way.
• Use large pictures and visuals that the whole group can see easily, or pass small ones around for each member of the group to look at individually.
• Ask questions.
• Start a discussion.
• Summarize the important points on the blackboard or on large sheets of paper.
• Use a handout for the summary.
Having students discuss or talk together is an effective way of learning. Discussion challenges students to examine their own views and to discover new ideas and attitudes. Use discussion to help trainees recognize that they have things to learn from others in the group, as well as things to teach others. This is an effective way to help the group work together to solve a problem.
Discussions are useful because the process enables students to talk about their own views, compare them with those of other members and gain more understanding about topics and issues. The trainer can also learn more about the ideas and feelings of the trainees through these discussions.
The trainer's role as a discussion leader
Play a quiet, behind-the-scenes role in helping trainees discuss things. Although you may know the subject well, do not force ideas on the group. Instead, encourage trainees to talk. Listen carefully, knowing that trainees will learn by example how to facilitate discussion among people in the community.
Ways you can facilitate a group discussion
• Guide the discussion. Keep it going by asking questions.
• Ask questions that help the group to:
• look at the problem;
• discover the causes of the problem;
• talk about possible solutions to the problem;
• choose the best solution;
• consider how to bring about the solution.
• Encourage quiet people to take part, and stop any one person from talking all the time. Minimize the amount of talking that you do.
• Keep the discussion on the topic as much as possible.
• Allow people to express different ideas, but introduce facts and knowledge that will make the discussion clearer.
• Be aware of feelings in the group, and try to stop the discussion from becoming too emotional or disturbing.
• Decide when it is no longer appropriate to discuss a certain issue in the group.
• Assure trainees that although learning to help or lead discussions takes time and practice, it is a useful skill that they can develop with practice in the community.
Role-playing is a very effective teaching method. It is a situation where trainees (and sometimes the trainer as well) pretend to be other people and act out a drama in front of the training group. Each person takes on the role of someone else and speaks and acts as they think these people would in a given situation. The rest of the group watches and pretends that the role-players really are the people they are pretending to be. The group learns by seeing and discussing how people behave in a certain situation.
Role-plays have proven effective in teaching THPs communication and counselling skills, and leadership skills, which include the facilitation of community discussion groups. Role-playing is useful in these and other settings because it helps trainees understand how others feel, gives them confidence as they practise skills, and gives them valuable feedback from class members who observe the role-play.
How to use role-playing
• Choose a topic or problem.
• Define the roles and the actors who will play them.
• Describe the situation carefully, so that the class and the players will understand the characters and the problems likely to be encountered.
• The "actors" can then present the role-play in front of the rest of the class. Or, pairs of trainees can take turns acting out the situation.
• The whole group can then discuss what happened. Ask various students how they might have behaved and invite discussion from the group.
• Summarize the discussion by pointing out the ideas and problems raised. Discuss how this situation may be related to students' jobs and what they can learn from it.
Giving a demonstration
Giving a demonstration can be very effective, because it shows people how to do something (demonstrates a skill), and it reaches a number of people at one time. Demonstrations are also effective in making an idea easier to understand. For example, it is easier to learn how to make a weaning food for a baby by watching it done, than by being told how to do it in a lecture. The best way is to watch it being done, and then to do it yourself. People learn best when they use all their senses, i.e., sight, hearing, touch, taste and smell.
To plan a demonstration
• Decide what the trainees need to learn.
• Make step-by-step notes on how you will give the demonstration, and on what you will tell trainees at each step.
• Prepare all the materials for the demonstration. Use things that can be found in the community, such as local foods and equipment.
• Practise doing the demonstration until it is easy for you.
To conduct a demonstration
• Explain what you are going to do and why.
• Explain and show each new practice or habit step-by-step.
• Be sure everyone can see what you are doing.
• Repeat any steps that are difficult.
• Ask trainees to help you with the demonstration.
• Speak loudly, clearly, and simply. Be as natural as you can.
• Follow the step-by-step notes you made beforehand.
• When you finish, ask some of the trainees to do one or more of the steps, so that you can check on how well they have understood. This gives them a chance to practise.
• Ask the group what they have learned from the demonstration.
• Summarize important points.
Encourage discussion afterwards and show how trainees can use demonstrations in their work
• Ask trainees what they liked best about the demonstration, what they learned, and what parts might be changed so they might better understand.
• Discuss how and when trainees might use demonstrations with families and community members.
Other training methods
The most commonly used training methods for THPs have been described in some detail. There are some additional methods that may be useful in teaching certain ideas and concepts. These methods include the use of games, dramas, music (songs), stories and puppet shows. For information on how to use these methods, consult the training manuals listed in the references.
Trainees may practise and begin to learn something in a training session, but to learn it completely, they will need to repeat it, or have it reinforced in other ways. The following are some ways to reinforce learning:
• Summarize what has been learned at every session.
• Review at the beginning of each session what was learned at the last.
• Ask trainees what they have done to follow up on what they have learned. For example, did they use it with a family or in a community setting?
• Use visual aids to show relevant information. For example, put up posters and materials in the training room and ask trainees to read and study them.
• Bring in resource people who already have experience and know the information you are teaching.
• Give students plenty of opportunities to practise what they have learned and give them constructive feedback on how well they are doing.