Module 3: Training School Teachers to Deliver Health Education Messages to Their Students

What are effective practices to train teachers?

In order to implement effective school health education programs, a large number of teachers in developing countries need to be trained to teach students about best health practices. The provision of pre-implementation training has been found to increase the integrity with which teacher implement a curriculum. The success of educational programs depends on the extent to which teachers are provided with suitable training and support in the participatory teaching methods required for this type of education.(1) There are many ways that teachers can be effectively trained.  Training should aim to specifically meet the skills that educators need in order to implement the programs. Teachers could be trained using educational training sessions with trainers or public health providers on certain health topics, or via the use of information technology tools such as computers, interactive software, and internet programs.  A study by Ahmed et al. evaluated teacher training for an AIDS prevention programs in South Africa. The training for the teachers was provided by an experienced HIV trainer who was familiar with the curriculum. The trainer was fluent in two of the three dominant languages and had 10 years of experience in the field of HIV training.  The objectives of the training program were to equip teachers with the necessary knowledge to confidently and effectively implement the curriculum. The training focused on factual information since teachers in the South African education system are not trained in sexual health education. The training was experiential in nature, and the teachers actively engaged as participants in all the lessons of the curriculum.(2)

In a study by Chao et al., an evaluation was made between two educator-training methods for an HIV/AIDS curriculum in South Africa. The study compared the use of interactive CD-ROMs with a two-day Life Skills Training Program provided by the Department of Education. The outcomes both before and after the interventions were measured by surveying the teachers’ knowledge about HIV/AIDS and their self-efficacy with respect to dealing with HIV/AIDS in the classroom setting. Both interventions proved to be effective in communicating knowledge and attitudes about HIV/AIDS topics. Overall, the Life Skills Training Program proved superior in enhancing basic knowledge about HIV, and the CD-ROM was superior in teaching about HIV transmission risks. In this particular case, given that the two interventions impacted the outcomes, the study concluded that the interventions could potentially be used together to improve the educators’ overall knowledge and abilities to teach the information. There was a near universal consensus that the CD-ROM was very useful in facilitating the learning of issues, and that they would recommend similar computer-based exercises for other educators.(3)

What are ineffective practices?

As described by Ahmed et al., interactive and experiential workshop-type training sessions were agreed to be most effective in facilitating the teachers' ownership of the curriculum. Reports demonstrate that this type of active training leads to more faithful implementation of programs, in contrast to methods such as video training. However, although training sessions were thought to be useful on the receiving end of teachers, the objective of enabling the transfer of knowledge and skills to the classroom was not successfully achieved. Teachers described feeling uncomfortable with role-play teaching, a method that was advocated in the training sessions. “After the initial training, teachers had inadequate and inaccurate knowledge of sexual reproductive health and HIV." This emphasizes the need for teacher training to incorporate professional development for teachers with a training program that enables teachers to empower their students with the information. "Bursts of sex education training will not be sufficient for teachers to internalize the factual information.”(4)

How do you ensure that the health message is understood by the teachers and communicated accurately to the students?

While training may be successful in the short term, it is important to ensure that educators successfully receive the training message, and that they transfer the knowledge and skills acquired to the classroom students. As previously described, in the study by Ahmed et al., the interactive and experiential workshops were found to be effective. However, the objective was not successfully achieved because teachers were unable to retain all of the information taught. Thus, the primary way to ensure that the messages will remain with educators is to implement long-term training programs, as opposed to fragmented training sessions that leave gaps in knowledge. (5)

Secondly, there should be follow-up with teachers and students, as well as pre- and post-training sessions to measure the outcomes of the teacher training program. Follow-up with teachers should not only be done immediately after training, but also a significant time afterwards to measure their understanding. This is perhaps the most important component of implementing training programs. Unless the message is understood and in turn accurately communicated to students, the program is useless. The follow-up may be best evaluated through a questionnaire for both educators and students. In the study by Ahmed et al., questionnaires were administered prior to the training, on completion of the training, and at two follow-up time periods, which were analyzed along with participant observation notes. Anonymous evaluation questionnaires with open-ended statements and questions were given to the teachers. The questionnaires provided the following information: (i) prior to the training: brief demographic data, expectations of the training, beliefs and values about teenage sexuality, comfort teaching material to youth, areas of discomfort, belief of skills required to teach sex education; (ii) on completion of the training: understanding of, and feelings about the curriculum, extent to which underlying messages in the curriculum matched personal beliefs and values, level of comfort and confidence teaching the curriculum, foreseeable challenges, aspects of the training which were useful, enjoyable and personally challenging and (iii) on completion of each of the two refresher trainings: experience of the curriculum, engagement of students, skills and knowledge applied from training or lacking from training, confidence and comfort teaching the curriculum, avoidance of lessons, support needs.(6)

As described in the study by Mukoma et al., student reception of the information was evaluated as well. Researchers conducted classroom observations, where each teacher was observed during one lesson. Focus group discussions with students were also carried out. The discussions lasted one hour, and the evaluators noted students’ experiences of the intervention and perceptions of its impact. The discussions were conducted in the students’ language of choice.(7)

Footnotes

(1) Ahmed N., Flisher A.J., Matthews C., Jansen S., Mukoma W., Schaalma H. Process evaluation of the teacher training for an AIDS prevention programme (2006) Health Education Research, 21 (5), pp. 621-632.

(2) Ibid.

(3) Chao, L., Gow, J., Akintola, O., & Pauly, M. (2010, February 28). A comparative evaluation of two interventions for educator training in HIV/AIDS in South Africa. International Journal of Education and Development using ICT [Online], 6(1).

(4)Ahmed N., Flisher A.J., Matthews C., Jansen S., Mukoma W., Schaalma H. Process evaluation of the teacher training for an AIDS prevention programme (2006) Health Education Research, 21 (5), pp. 621-632.

(5) Ibid.

(6) Ahmed N., Flisher A.J., Matthews C., Jansen S., Mukoma W., Schaalma H. Process evaluation of the teacher training for an AIDS prevention programme. Health Education Research. (2006). 21 (5), pp. 621-632.

(7) Mukoma W, Flisher AJ, Ahmed N, Jansen S, Mathews C, Klepp KI, Schaalma H: Process evaluation of a school-based HIV/AIDS intervention in South Africa. Scand J Public Hlth. (2009). 37(Suppl 2):37-47.