Trainings

BASIC LIFE SUPPORT - TRAINING OF TRAINERS

Published: Feb 23, 2012

I.  Rationale

Realizing the need to reduce morbidity and mortality, the DOH issued Administrative Order No. 155 that prescribes Basic Life Support (BLS) Training as mandatory to all health personnel/health workers since they should no longer be confined in health care facilities but they are expected to respond in any event of emergency or disaster if deemed necessary.

The initial timely and effective response to emergency includes measures to save lives and BLS is the foundation of all resuscitative efforts thereby building the importance of this training and the need to develop trainers in all health facilities and offices nationwide.

HEMS being mandated to develop and enhance capacities for emergency management envisions to train all health workers and as many members of the community, at least one member of each household since BLS response will ultimately save lives.

Specifically, Basic Life Support Course provides the Healthcare Providers and Lay Rescuers with the knowledge, skills, and attitude necessary in response to an emergency situation in order to help sustain life and minimize the consequences of respiratory and cardiac emergencies until more advanced medical help arrives.

II.  Course Objectives

 General Objective:

At the end of the training, participants will be able to acquire knowledge, develop skills, and exhibit commitment for them to be an effective DOH Basic Life Support Trainers.

Specific Objective:

 At the end of the course, the participants will be able to:

  1.  Explain the adult learning process involved in training and the three domains of learning.
  2. Discuss the principles and techniques in communication which can be utilized in any type of conversation and training.
  3. Demonstrate the required communication skills and good qualities of a good speaker or trainer.
  4. Describe the use and characteristic; and outline the guidelines and steps involved in the preparation of audio-visual aids being used in training.
  5. Execute the necessary training preparation including formulation of training-learning objectives, planning training sessions, and development of a training proposal.
  6. Discuss the proper classroom management and characteristics of a conducive learning environment.
  7. Integrate the revised DOH Guidelines and Policies on Basic Life Support Training.

 III.        Contents

 The following modules compose the BLS Training of Trainers sessions:

 Module 1 - Course Overview

  1. Legal Bases
  2. Types of BLS Training
  3. Course Objectives
  4. Scope & Coverage
  5. Course Evaluation

Module 2 - Learning Process

  1. Definitions of Learning
  2. Characteristics of Learning
  3. Principles of Learning
  4. Adult Learning Principles
  5. Domains of Learning

Module 3 – Communication

  1. Definition of communication
  2. Purposes of communication
  3. Communication Channels
  4. Communication Process
  5. Major dimensions
  6. Communication in Emergencies
  7. Strategic Communication Approaches
  8. Basic Elements of Communication

Module 4 - Communication Skills

  1. Characteristics of Communicator
  2. Channels of Communication
  3. Barrier against Effective Interpersonal Communication
  4. Overcoming the Barriers of Effective Interpersonal
  5. Communication

Module 5 - Medium of Communication

  1. Types of Communication Media
  2. Advantages and Disadvantages of Media
  3. Steps in Preparation of Communicative Visuals
  4. Learning Re-enforcers
  5. Application on the use of different communication media

Module 6 - Training Preparation

  1. Definition of objective
  2. Types of objectives
  3. Two levels of learning objectives
  4. General and specific learning objectives
  5. Instructional design process
  6. Training Work Sheet/Work Plan for Basic Life Support

Module 7 - Classroom Management

  1. Classroom Management
  2. Classroom Setting/Arrangement
  3. Pros and Cons of Room Setting
  4. Training Checklist
  5. Rules in choosing and using presentation media 

Module 8 - BLS Skills, Policies, Guidelines, and Procedures

  1. Course Content
  2. ID Issuance and Renewal
  3. Training Duration
  4. Roles and responsibilities
  5. Skills review, enhancement, and standardization
  6. Evaluation

Module 9 - BLS Updates
 

IV.        Methodology

 The following adult learning strategies will be employed for this combined technical-skills training:

  1.  Interactive Lecture-Discussion
  2. Audio Visual Presentation
  3. Demonstration and Return Demonstration
  4. Practicum
  5. Skills Enhancement
  6. Examination /Evaluation (Written and Practical)

 V.        Operational Details 

Venue

Canvassing to be done by the host region

Date

5 day + 1 day Facilitator’s Meeting

No. of Participants

50 participants

No. of Facilitators

10 facilitators

No. of Resource Speaker/s

1 Course Coordinator

No. of Support Staff

2 documentors/administrative staff

Proposed Budget

Php 600,000

     Meals & Accommodation

Day 1: 15,600 (Facilitators & Support Staff)

Day 2: 75,600 (Facilitators, Support Staff, and Participants)

Day 3: 75,600 (Facilitators, Support Staff, and Participants)

Day 4: 143,100 (Facilitators, Support Staff, Participants/Practicumers, and Student-Participants )

Day 5: 143,100 (Facilitators, Support Staff, Participants/Practicumers, and Student-Participants )

Day 6: 15,600 (Facilitators & Support Staff)

     Supplies/Materials

Php 45,000

     TEVs

 

     Honorarium

 

     Gasoline/Vehicle Rental

Php 162,000

Fund Source

GOP

 VI.        Course Evaluation

A. Course

At the start of the training, leveling of expectations is conducted to assess the learners and develop the setting. A day to day debriefing is done involving the facilitators and assigned host team in order to evaluate the day’s session in terms of its strengths and weaknesses and generate recommendations for improvement of the succeeding days.

At the end of the course, the participants are given the opportunity to indicate what they thought about the course. The administration of the terminal evaluation will provide feedback concerning the course including course content, time management, training materials and methodologies; and the knowledge and expertise of the speakers, venue and other administrative arrangements.

 The training report is prepared in order to have a written document for reviewing past training accomplishments and reference for future training.

B.
Participants/Trainees

Participants of BLS for Healthcare Provider and Lay Rescuer must pass both the written and practical examinations. Cognitive learning is assessed through the use of a written examination while the psychomotor proficiency is evaluated using skills sheets in a practical examination. Both examinations offer concrete proof for passing or failing each participant and minimize issues of subjectivity and bias.

A.   Evaluating Participant’s BLS Skills 

1. Mechanics of Evaluation

    a. Cognitive Evaluation

1)  A multiple-choice type written examination of 50 items and given within an hour is the acceptable method of cognitive evaluation in BLS training.

2)  Trainers should take the initiative to update and modify the questionnaires as needed, but should generally confine questions to those that test for knowledge, comprehension, and application of BLS lessons.

3)  Questions that require analytical thinking should be avoided as much as possible especially in BLS training for lay rescuers.

4)  Exercises after each session are as well administered in order to immediately assess attainment of the objectives

b. Psychomotor Evaluation

1)  A practical examination utilizing the skills sheets, CPR manikins, and other available training devices in a simulated environment is the standard method of psychomotor evaluation in BLS training.

2)  Psychomotor evaluation is carried only out after skills demonstration, participant return-demonstration, critiquing and remediation, and pre-testing orientation has been conducted.

3)  The Trainer’s stations in BLS training for healthcare providers for 1 or 2 rescuers are as follows:

a)  Adult Station(FBAO, RB and CPR w/ or w/out AED)

b)  Child Station(FBAO, RB and CPR w/ or w/out AED)

c)  Infant Station(FBAO, RB and CPR)

4. )  The Trainer’s stations in BLS training for 1 or 2  Lay Rescuers are as follows:

a) Adult Station(FBAO and CPR w/ or w/out AED)

b) Child Station(FBAO and CPR w/ or w/out AED)

c) Infant Station(FBAO and CPR)

5) Psychomotor Testing Guidelines

a)  The participant must perform each step on the skill sheet correctly and in the proper sequence in order to pass. Whenever this is done, the trainer checks the box across the step in the column marked “P’ (for Passed).

b)  Whenever the participant either fails to perform a step or performs it in any substandard degree, the trainer will stop the test, point out the error, and tell the participant to repeat the step. The trainer marks the first NR (for Needs Remediation) box.

c)  Should a participant fail to perform a step or perform it in any substandard degree for a SECOND time, the trainer must stop the test, mark the next NR box (NR?), and set aside the participant for critical remediation.

d)  If a participant following critical remediation, still makes the same mistake, the trainer should stop the exam, mark the last NR box (NR?), provide final remediation, and warn the participant that he/she will automatically fail if the mistake is made again.

e)  During the exam, the trainer remains generally silent, providing direction to set the simulation and giving information only when an action performed by the participant requires it (i.e.: information like "no sign of breathing" will only be given by the trainer if the participant has properly checked for breathing).

f)  The trainer should focus on the critical skill steps and the appropriateness of the interventions. The trainer should not focus on minor issues such as whether a participant of Healthcare Provider BLS first put his or her fingers on the patient’s Adam’s apple before sliding them into the groove on the side of the neck to check for a pulse since what is important is that the participant’s fingers were in the right place to feel for the pulse and that the he/she took the proper time to evaluate for its presence or absence before beginning chest compressions.

B.  Computation of Grades

1.   Cognitive Evaluation Score

With written examinations, computing for a Cognitive Evaluation Score (CES) is done by dividing the sum of correct answers by the total number of questions and multiplying the result by 100.

 Formula:           CES       =         No. of correct answer         x 100%                                                                                 Total numbers of questions                  

2.  Psychomotor Evaluation Score

In computing for the Psychomotor Evaluation Score (PES), the individual skill station grades are first determined. Grading per skill station is done by subtracting from 100 the product of the number of marked NR boxes or remediations (r) multiplied by the corresponding scoring factor (sf), rounded off to the nearest whole number.

Determining the PES is done by averaging all the individual grades per skill station. The result is expressed in percent for computation purposes.

 Formula:           Skill Station Grade  =  100 - (r  x sf)

 PES (%)    =    Σ Skill Station Grades   

                              No. of Skill Stations 

HEALTHCARE PROVIDER BLS

SKILLS STATION

NO. OF SKILLS STEPS

SCORING FACTOR

Adult/Child 1-Rescuer CPR

12

2.08

Adult 2-Rescuer with AED

10

2.5

Adult/Child FBAO Management

19

1.32

Infant 1-Rescuer/2Rescuer CPR

14

1.78

Infant FBAO Management

4

6.25

  LAY RESCUER BLS

SKILLS STATION

NO. OF SKILLS STEPS

SCORING FACTOR

Adult/Child CPR

11

2.27

Adult CPR with AED

11

2.27

Adult/Child FBAO Management

19

1.32

Infant CPR

11

2.27

Infant FBAO Management

4

6.25

     

 3.  Computation of Final Grade

The Final Grade is computed by adding the weighted products of the CES, PES and AES. Cognitive evaluation makes up for forty percent (40%) of the final grade while psychomotor evaluation makes up fifty percent (50%) and affective evaluation comprises the ten percent (10%) of the total grade. The formula is as follows:

            Final Grade = (CES x 0.4) + (PES x 0.5) + (AES x 0.1) 

C. Passing Grades

1.  In order to pass BLS training, the participant must receive a score of at least 75% in both cognitive and psychomotor evaluations.

2.   For cognitive evaluation, the participant must answer correctly in at least 75% of the total number of questions in the written examination.

a)  The participant who fails to pass the written exam will be given a second chance to pass through a remediation exam. Again, the participant needs to correctly answer 75% of the total number of questions in the exam in order to pass.

b)  The participant who takes and passes a remediation exam will receive a grade of 75%, regardless of the number of correct answers achieved.

c)  The participant who fails the remediation exam automatically fails the training course.

3.   For psychomotor evaluation, the participant must achieve a minimum score of 75 in all skills stations outlined in his/her training course.

a)   The grade of all participants who require final remediation before passing is 75.

b)   Once the number of mistakes in a single skill step exceeds the number of remediation boxes, the participant automatically fails the course.

D. Remediation

1.  Ideally, trainers should exhaust all available time and effort to provide as many remediation as possible. Remember: The goal is to develop BLS providers.

2.  Cognitive remediation can be as simple as a retake or as intensive as a review of common mistakes followed by a remediation exam, depending on the available time.

3.  Simple remediation involves pointing out an error and reminding the participant of the correct method or procedure; critical remediation involves a quick repeat demonstration from the trainer and short practice (return-demonstration) for the participant prior to continuation of the test; and final remediation is similar to critical remediation but includes a stern warning that the participant automatically fails should he/she make the mistake again

 VII. Course Requirements

 The participants must be able to satisfy the following course requirements prior the issuance of the following:

 A.       Training Certificates

There are two types of certificates that shall be prepared, the Certificate of Attendance and BLS ID (Certificate of Completion). Issuance of certificates is the primary responsibility of the conducting party following the standard DOH-HEMS certificate forms. Certificate of Attendance shall be issued to participants during the formal or informal closing of the training, while the BLS ID will be issued one to four weeks after the training.

 1. Certificate of Attendance

 i. Issued to all participants with at least 90% attendance (10% absence/tardiness must be with valid reason/s and must not be more than 30 successive minutes per session.

 ii. For CHD training, signatories will be preferably the CHD Director and the HEMS Coordinator plus two trainers

iii. For hospital training, signatories will be preferably the Chief of Hospital and the HEMS Coordinator plus two trainers

iv. For training conducted by the Central Office (HEMS) signatories will be the Director of HEMS and the Course Director plus two trainers.

 2.   Certificate of Completion/BLS ID for Healthcare Providers and Lay Rescuers

  1.  Certificate of Completion/BLS ID shall be issued only to participants who have BLS Certificate of Attendance and passed the written and skills examinations
  2. It shall be released only after submission of the examination records signed by the Course Director.
  3. Validity period shall be two (2) years but subject for renewal/ revalidation after taking a revalidation examination or refresher course.
  4. Colors of the BLS ID shall be white for the background and orange for the text box of the word ‘HEALTHCARE PROVIDER’ or ‘LAY RESCUER’ in white font.
  5. For CHD training, signatories will preferably be the CHD Director and the HEMS Coordinator plus two trainers
  6. For hospital training, signatories will preferably be the Chief of Hospital and the HEMS Coordinator plus two trainers
  7. For training conducted by the Central Office (HEMS) signatories will be the Director of HEMS and the Course Director.

viii.

Example: Serial Number for CHD 10 or Northern Mindanao (use NM)

Serial numbers shall be indicated at the front and back of the ID following below format:

 Example of Serial Number for BLS Healthcare Provider:

Training

Year

Region

Number

BLSHP

11

CHDMM

0001

BLSHP-11-CHDMM-0001

 Example for BLS Lay Rescuer:

Training

Year

Region

Number

BLSLR

11

CHDNM

0001

BLSLR-11-CHDNM-0001

 ix.  For training conducted by DOH hospitals, acronym of the name of hospital shall be indicated before the number.

 Example:

 In case of BLS Training for Healthcare Providers conducted by the Tondo Medical Center, the serial number will be BLSHP-11-CHDMM-TMC0001

 

In case of BLS Training for Lay Rescuers conducted by the Tondo Medical Center, the serial number will be BLSLR-11-CHDMM-TMC0001

 

x.   Lost Certificate of Completion / ID are non-replaceable. Only “certification” will be issued in lieu of lost ID.

3. Renewal of the DOH BLS ID for BLS Healthcare Providers and Lay Rescuers

i.    BLS ID can be renewed after passing the written and skills examination administered by the CHD or hospital.

ii.    Those who did not pass the revalidation exam shall attend a Refresher Course conducted by the CHD or hospital

 4. Renewal of the BLS Trainer’s ID (every 2 years)

i.      Trainer’s ID can be renewed, signed by National Course Director and the HEMS Director, after submission to the HEMS office of the ff:

  1. Training Report per conducted BLS course (minimum of eight courses for two years).
  2. Photocopy of signed Attendance Sheet of Participants per course.

 B. Submission of Reports by Trainers within a month after training

  1.  Examination Records of the BLS participants must be accomplished by the DOH BLS Trainers in three (3) copies and signed by the training coordinator to be submitted to the conducting agencies and CHD
  2. Training coordinator shall keep a copy of the examination records
  3. The CHD should keep a directory of all trainings conducted within the region.
  4. In addition, the CHD will also submit annual report of the BLS Training Accomplishment within the region to DOH-HEMS.

 Schedule of Activities

 

Day/ Date

Time

Topic/ Activity

Resource Person/ Facilitator

Day 0 (SUNDAY)

 

 

  • Departure & Travel Time
  • Arrival & Check-in of Facilitators
  • Facilitators Meeting

a)  Tasking

b)  Levelling

c)  Knowledge & Skills Standardization

  • Arrival of Participants
  • Registration
  • Check-in of Participants
  • Secretariat / Support Staff
  • Facilitators
 

Day 1 (MONDAY)

8:00 – 10:00

 

 

  • Opening Ceremonies
  • Introduction of Facilitators
  • Introduction of Participants
  • Levelling of Expectations
  • Course Overview/Mechanics of the Course

a)  Course Introduction

b)  House Rules

c)  Course Requirements

 

 

 

 

 

 

 

 

10:00 - 11:00

 

11:00 – 12:00

 

  • Learning Process

 

  • Communication

 

 

11:00 – 12:00

 

LUNCH

 

 

1:00 – 2:00

  • Communication Skills & Medium of Communication
  • Workshop

a)  Verbal Communication Skills

b)  Small Group Communication using Various Medium of Presentation

 

Breakaway into 5 groups with assigned facilitators

 

5:00 – 6:00

  • Training Preparation

 

 

6:00 – 7:00

  • Classroom Management

 

 

7:00 – 8:00

DINNER

 

 

8:00 – 9:00

PIE (Post Intervention Evaluation)

 

 

Day 2 (TUESDAY)

8:00 – 8:30

  • Recapitulation

 

 

8:30 - 12:00

 

 

  • BLS Review & Enhancement

a)  AED Lecture

b)  CPR Knowledge & Skills Enhancement

 

 

 

12:00 – 1:00

LUNCH

 

 

1:00 - 3:30

 

  • BLS Policies & Guidelines and Certification

 

 

3:30 – 4:30

  • Written Examination (BLS-Basic)

 

 

4:30 – 6:00

  • Teaching Preparation
  1. Teaching Theory Practice:

a)  Computation of Grades

b)  Preparation of Examination

c)  Trial Recording of Classes

  1. Preparation of materials / needs for Teaching Practicum

Breakaway into 5 groups with assigned facilitators

 

 

PIE (Post Intervention Evaluation)

 

Day 3 (WEDNESDAY)

    8:00 - 5:00

  • BLS Practicum (Didactics)

Practicum Site

 

5:00 – 6:00

PIE (Post Intervention Evaluation)

 

Day 4 (THURSDAY)

8:00 – 5:00

 

  • BLS Practicum (Skills & Examinations)
  • Graduation

Practicum Site

 

5:00 – 6:00

  • PIE (Post Intervention Evaluation)

 

 

6:00 – 7:00

  • Plenary PIE

 

 

7:00 – 9:00

  • Dinner & Closing Program

 

Day 5 (FRIDAY)

PM

DEPARTURE

 

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