For four decades, Jhpiego has led training innovations around the globe. Beginning with innovative approaches to training physicians to perform laparoscopic surgery for diagnostic and therapeutic purposes, to using low-cost operating loupes (goggles) for microsurgery, Jhpiego has been a leader worldwide in training of health care providers.
The publication of Jhpiego’s Clinical Training Skills for Reproductive Health Professionals manual in 1995, perhaps more than any other event at Jhpiego, changed the direction of training. In this landmark manual, Jhpiego’s future path was set, with the introduction of competency-based learning guides and checklists and the use of the humanistic approach to training in which service providers had their clinical skills standardized on an anatomic model before moving on to clients for almost every clinical procedure.
Until that time, a typical course on the intrauterine device (IUD) took six weeks, and did not include the use of anatomic models. Jhpiego worked closely with a manufacturer to create a pelvic model, allowing learners to master the skill in simulation before working with clients. This innovation broke new ground in evidence-based, humanistic training by decreasing the time required to achieve competency, reducing stress for the learner and potentially reducing the risk of adverse events with clients.
In 1994, this approach to clinical training was tested in Thailand. Jhpiego and Chulalongkorn University evaluated this then-revolutionary use of models in training by comparing the numbers of clients required for a learner to achieve competency in IUD insertion. In the intervention group, 70 percent of the 150 providers who were trained using models demonstrated competent performance of IUD insertion after practice on one client. In comparison, in the control group, only 18 percent demonstrated competent performance after practice on one client. Even after practice on eight clients, only 71 percent of the control group demonstrated competency in IUD insertion, compared to 97 percent of the intervention group, who demonstrated competency after just three clients. As a result of this study, the Government of Thailand adopted the use of competency-based training with models (i.e., the humanistic approach), and the length of training for midwives in IUD insertion was reduced from six to two weeks. The approach became the “gold standard” for clinical training, not only for Jhpiego but for sister agencies around the world. The results of this study were published in the British Journal of Family Planning in 1997.