Training the Trainers in Ethiopia

Effective teaching, mentorship, and leadership skills are essential for faculty success in academic medicine, but these skills are rarely taught in medical school and residency training programs, particularly in low-resource settings. To address this gap among anesthesia educators in Ethiopia, a 13-week course was developed and piloted in a virtual platform from September 2020-January 2021. The Training of the Trainers (TOT) Course for Physician Anesthesia Educators was developed by faculty, staff, and student leaders in the Vanderbilt University Medical Center Department of Anesthesiology and the Vanderbilt Institute of Global Health (VIGH) through the Improving Perioperative Anesthesia Care and Training (ImPACT Africa) program. The course expanded a previous in-person course on educational best practices and medical simulation and built upon previous collaboration between ImPACT Africa and VIGH to develop an online research methods course developed in Kenya.

Fifteen anesthesia educators at six medical institutions across Ethiopia were selected to participate in this pilot course, taught by Dr. Bantayehu Sileshi, Dr. Marie Martin, and Elizabeth Rose and supported by Claire Posey. The course was taught using a flipped-classroom approach in which trainees became familiar with course content prior to class through video lectures and readings. During class sessions, trainees built on prior knowledge through group discussions and activities.

The COVID-19 pandemic offered a unique opportunity to deliver this course via digital platforms. Trainees accessed course materials through YouTube and an online learning management system (LMS). Weekly class meetings were conducted over Zoom. Telegram was used for quick communication about course materials and meetings.

In the ToT course, trainees learned how to develop effective student-centered courses using active learning techniques and theories. At the end of the course, trainees demonstrated these skills through a final culminating project that included a didactic presentation and a case-based discussion. Trainees also learned how to align learning activities with course goals and student learning objectives, as well as create assessment plans and tools to evaluate learner growth.

Additional focus in the course was given to understanding how to apply documented principles of mentoring to empower mentees, foster independence, and positively influence the mentoring culture, as well as how to integrate effective leadership practice into their work. As one participant noted, “I will be a leader at any site. After the training, I believe that I can bring a change wherever I am.” Trainees are beginning to incorporate these lessons into their practice, strengthening their teams within their hospitals.

Preliminary results from pre- and post-course evaluations showed a positive change in trainees’ knowledge, skills, and attitudes related to practice in teaching, mentoring, and leading. Moreover, participants noted that it builds a community of learners and helped to“create friendship between [them] and other universities. We learn a lot as effective university instructors.” While the course was taught through virtual platforms because of travel restrictions resultant from the pandemic, it helped link learners across multiple institutions and countries.

This course was built on the train-the-trainer model, in which trainees were equipped to teach future iterations of the course. Based on the successful implementation of this course in a virtual format, the course is now being replicated in Tanzania for nurse and physician anesthesia educators. Four Ethiopian course alums are facilitating course delivery, and plans are underway for Tanzanian alums to lead future courses in Tanzania.

Online courses taught by Dr. Bantayehu Sileshi, Dr. Marie Martin, and Elizabeth Rose and supported by Claire Posey.