Management training in Vietnam's National Tuberculosis Program: an impact evaluation.

SETTING: National Tuberculosis Program (NTP), Vietnam. OBJECTIVES: To show how the Sustainable Management Development Program (SMDP) of the US Centers for Disease Control and Prevention created capacity within Vietnam's NTP to organize a management training program, and to assess the influence of the NTP's in-country training program on individual and team management practices and the performance of provincial TB control programs. DESIGN: Eight case studies of participating provincial TB organizations, including cross-case and content analysis. RESULTS: Participants and their back-home learning project teams demonstrated a solid understanding of the concepts taught, particularly evidence-based decision making, problem diagnosis and problem solving, and using teamwork to improve results. They gave multiple examples of how they use these concepts in their daily work. Project teams exceeded, attained or very nearly attained their target objectives, including improved DOTS implementation. Process improvements had become a routine part of their practice and were often diffused to other districts. Several teams said they now took more initiative in identifying problems and devising solutions. Others said that increased teamwork was improving the commitment of the NTP staff. CONCLUSION: Management training, including applied projects with coaching, can improve managerial and program performance of NTPs.

"We're living what we're learning": student perspectives in distance learning degree and certificate programs in public health.

The authors used surveys and interviews to study participants' motivations for enrolling and perceptions of the weaknesses and strengths of two distance learning programs administered by the University of North Carolina at Chapel Hill School of Public Health (SPH): the MPH in Public Health Leadership and a certificate program organized collaboratively with the Mahidol University SPH in Thailand. Chief motivations were career advancement, job performance improvement, convenience, and obtaining a degree from a reputable institution. Strengths included the curriculum, networking opportunities, and administrative and technical support. Concerns included quality of interaction with faculty and instructional methods.

Effects of traditional classroom and distance continuing education: a theory-driven evaluation of a vaccine-preventable diseases course.

OBJECTIVES: This study evaluated the effects of a major federal immunization continuing education course, delivered in both traditional classroom and satellite broadcast versions, on public health professionals' knowledge, agreement, self-efficacy, and adherence in practice to recommendations. METHODS: The study used a comparative time series design to determine whether the course influenced participants' knowledge, agreement, self-efficacy, and adherence in practice to general and polio-specific recommendations as measured immediately and 3 months after the course. It also compared the effects of the classroom and satellite broadcast versions and used path analysis to show how the outcomes were related to one another. RESULTS: Both versions significantly improved knowledge, agreement, self-efficacy, and adherence. Knowledge and agreement were significant predictors of self-efficacy, which directly predicted adherence. Vaccine availability and supportive clinic policies were also important adherence predictors. CONCLUSIONS: A well-designed training update can change provider knowledge, agreement, self-efficacy, and adherence. Traditional classroom and distance training can have comparable effects. The findings support incorporation of distance learning in national public health training, if the distance learning is used wisely in relation to training needs, goals, and practice contexts.

Impact studies in continuing education for health professionals. A critique of the research syntheses.

Documenting impact has been a continual pursuit in continuing education (CE) for health professionals. Hundreds of primary impact studies have been published, along with 16 impact study syntheses that have sought to generalize about the effectiveness of CE and sometimes how and why the effects occur. This article describes and critiques the methodology of the 16 syntheses and summarizes their findings. A first wave of syntheses established a general causal connection between CE and impacts, but explained impact variability only in the dependent variable-knowledge, competence, performance, or outcome. A second wave added a search for causal explanation through analysis of variables that moderate impact. This wave has begun to identify the most appropriate types of programs for promoting performance changes. The article concludes by suggesting questions and methods for future primary studies and meta-analyses, including improved experimental and meta-analytical methods, along with case and naturalistic studies and action research.