Retraining of family physicians in Armenia addresses the primary healthcare practice needs

Background: Establishment of Family Medicine (FM) as primary healthcare (PHC) system in Armenia  stipulated the need to revise the PHC providers retraining appropriate to the new scope of work.  Hundreds of PHC physicians will complete a one-year specialty training by 2012, the process started in 2000.The specialists involved as trainers experienced difficulties in addressing the PHC needs, the training content was different in Yerevan State Medical University and the National Institute of Health.
Design and Implementation: In 2005 the USAID funded Primary Healthcare Reform Project evaluated the training process and started a program to address the identified gaps. The Project supported the development of training packages on selected modules using prioritization matrix for topic selection. Training packages were developed using the "Learning for Performance" instructional design methodology by IntraHealth International, which requires development of training materials according to identified learning needs.

The lack of clinical care protocols in the country was addressed through creation of evidence based “Quick reference guides” for management of certain clinical conditions. Health education materials were developed on health conditions identified as major public health concern and used for patient education sessions. Training of trainers courses were conducted to prepare trainers for the module. The modules were incorporated into the Family Physicians retraining programs. The program implementation was monitored through site visits, self-assessment questionnaires, performance direct observations.
Results
40 faculty members and clinical preceptors completed the ToT course for each module. Specific learning objectives of the training of trainers courses were achieved by 100%. Implementation of training packages within the specialty training curriculum increased the learners and trainers satisfaction due to well designed training materials. Implementation of the training packages lead to standardization of teaching in different training organizations.
Conclusions
The development of systematically designed training packages for certain modules and preparation of trainers through training of trainers courses is recommended in clinical teaching and health education.