A train-the-trainer education and promotion program: chronic fatigue syndrome – a diagnostic and management challenge

Abstract

BackgroundChronic fatigue syndrome (CFS) is a complicated illness for providers and patients. Fewer than 20% of persons with CFS have been diagnosed and treated. For providers, compounding the issue are the challenges in making a diagnosis due to the lack of a biomedical marker.MethodsThe objective of the CFS diagnosis and management curriculum was to instruct core trainers as to the evaluation, diagnosis, and management of CFS. Over a two year period, 79 primary care physicians, physician assistants, and nurse practitioners from diverse regions in the U.S. participated as core trainers in a two day Train-the-Trainer (TTT) workshop. As core trainers, the workshop participants were expected to show increases in knowledge, self-efficacy, and management skills with the primary goal of conducting secondary presentations.ResultsThe optimal goal for each core trainer to present secondary training to 50 persons in the health care field was not reached. However, the combined core trainer group successfully reached 2064 primary care providers. Eighty-two percent of core trainers responded "Very good" or "Excellent" in a post-tessurvey of self-efficacy expectation and CFS diagnosis. Data from the Chicago workshops showed significant improvement on the Primary Care Opinion Survey (p < 0.01) and on the Relevance and Responsibility Factors of the CAT survey (p = 0.03 and p = 0.04, respectively). Dallas workshop data show a significant change from pre- to post-test scores on the CFS Knowledge test (p = 0.001). Qualitative and process evaluation data revealed that target audience and administrative barriers impacted secondary training feasibility.ConclusionData show the workshop was successful in meeting the objectives of increasing CFS knowledge and raising perceived self-efficacy towards making a diagnosis. The CFS TTT program informed an educational provider project by shifting the format for physicians to grand rounds and continuing medical education design while retaining TTT aspects for nurse practitioners and physicians assistants. Evaluations also indicate that secondary trainings may be more readily employed and accepted if administrative barriers are addressed early in the planning phases.

Access to Medical Care for Individuals with Myalgic Encephalomyelitis and Chronic Fatigue Syndrome: A Call for Centers of Excellence

“…CDC’s Medscape course, “train-the-trainer” models, etc. [13]), continued patient dissatisfaction with medical care suggests that physicians may require longer-term mentorship in the ME and CFS diagnosis and treatment. Such mentorship could be provided at established Centers of Excellence.…”

The effect of the SAFE or SORRY? programme on patient safety knowledge of nurses in hospitals and nursing homes: A cluster randomised trial

“…While many studies describe the effectiveness of an educational intervention to change health care professional practice and behaviours (Freemantle et al, 2000;Jamtvedt et al, 2006;O'Brien et al, 2007;Farmer et al, 2008;Reeves et al, 2008;Gagnon et al, 2009;Forsetlund et al, 2009), fewer studies describe the effectiveness of an educational intervention on knowledge of health care professionals (Brimmer et al, 2008;Chan et al, 2009;Gunningberg, 2004;Wallace et al, 2006). Most of these pre-and post-test studies on knowledge did describe an increase of knowledge, but none of these studies had a control group.…”

Translation of a comprehensive health behavior intervention for women living with HIV: the SMART/EST Women's Program

“…The model included the selection, training, and technical support of qualified CHC staff that would be systematically trained to ultimately assume independent leadership of the program. This "train the trainer" model has been used in a variety of health-care settings [25]. Health-care providers, counselors, social workers, and health educators (n=14) with education ranging from associate's to master's and doctoral degrees were trained by research staff to teach other providers and then returned to their CHCs to disseminate the training to other staff members.…”