Knowledge Item: CA-Training Impact: Patient Care-04
Percent of Trainees Reporting Changes in Patient Care or the System of Care

A cross-cutting telephone study of 218 service providers was conducted. Providers were interviewed an average of eight months after a HIV/AIDS training experience about possible changes that they observed in their own practice and at the larger system level as a function of the experience. Overall, trainees viewed their experience as "very" valuable and effective, often recommending the training to at least one other person and sometimes several others. 

Open-ended responses from the interview were coded by three independent judges for examples of shifts in how the trainees provide care to their patients with HIV/AIDS. "Patient Care Change" was defined as a clear mention by the trainee that different clinical care procedures were being followed now, as a result of the information acquired during the training experience. Interrater reliabilities were relatively high across all eight questions.

Across the entire interview nearly all trainees (82.1 percent) mentioned at least one concrete example of patient care change due to the training experience (mean = 2.11 mentions; s.d. = 1.66 mentions). 

Open-ended responses from the interview were coded by three independent judges for examples of system change. "System change" was defined as a clear mention by the trainee that different procedures and guidelines were being followed due to the information acquired during the training experience. Training impact, as defined here, extended beyond the single trainee and affected behavior of several individuals at the larger level. Inter-rater reliabilities were relatively high across all eight questions.

Across the eight interview questions, about half of the trainees (55.5 percent) provided at least one instance of system change as a function of the training experience(s).

Almost all of the trainees (86.7 percent) gave one or more examples of patient care or systems change as a direct result of the training. 

Note: A related set of Knowledge Items assess how the training affected the health care systems at the agencies of the individuals trained.

The coding of patient care change was done by Bernadette Lalonde, Ph.D., and Karina Uldall, M.D., of the University of Washington using open-ended responses to questions in the training follow up semi-structured interview conducted by The Measurement Group.

Knowledge Item Citation: Huba, G. J.,  Panter, A. T., Melchior, L. A., and the HRSA/HAB SPNS Cooperative Agreement Steering Committee (1998-2001). Knowledge Item: CA-Training Impact: Patient Care-04 from HRSA/HAB's SPNS Cooperative Agreements on Innovative Models of Care, The Measurement Group Knowledge Base on HIV/AIDS Care, Online at www.TheMeasurementGroup.com.